The Analysis Of Endoscopic Treatment For Achalasia

Objective:Through the collection and analysis of the general information anddata of268achalasia patients before and after treatment in endoscopy center，Comparing single endoscopic balloon dilatation, double balloon dilatation and endoscopic ring myotomy (POEM) in the treatment of achalasia patients with flacciddifference in efficacy, complications, recurrence.Method:Selecting268cases of achalasia patients who ware diagnosed and treatedin Shenyang Military Region General Hospital endoscopy center from2009to2013.Allthe achalasia patients are divided into single balloon dilatation group, the doubleballoon dilatation group and POEM group by different treatment,Each group patientsare divided into I, II, III, IV level.Record the number of cases of achalasia patients indifferent gender and age,To analysis Whether there is statistical difference ornot,Comparing I, II, III, IV level patients in single-balloon dilation and double-balloonexpansion with the efficacy of the treatment, the recurrence time, and the changingdiameter of lower esophagus before and after treatment, Comparing III, IV patients withthe complications, efficacy and the changing diameter of lower esophagus after doubleballoon dilatation and POEM treatmentResults:Single balloon dilatation compared with double-balloon dilatation1:Efficacy: I level patients with two treatment groups showed100%effective, and There was a significant difference in efficacy II-IV level patients with both methods.2:Complications: Patients in both treatment had a small amount of bleedingbut no perforation, The statistical results showed no difference between the twocomplications.3:Follow-up case：Double balloon dilatation’s efficacy was better than singleballoon dilatation’s after1month,3months and1year. There was a difference on the lower esophagus diameter which is a compensatory expansion both beforeand after treatment in a month, but there was a significant differences on threemonths later, Double-balloon dilation’ diameter was less than single balloon dilatation’s. Single balloon dilation group’ recrudescence was significantly shorter than the double-balloon dilatation’s, and the statistical results showed a significant difference.Double balloon dilatation compared with POEM treatment1:Efficacy: There was no difference in efficacy for III patients of two group,but double-balloon dilatation group’ efficiency was lower than POEM But thereis a statistically significant difference for IV level patients, and the patients’’ significant efficiency of POEM group was higher than patients of double-balloondilatation group.2:Complications: The double balloon angioplasty was superior to POEM group on complications,and the data about bleeding showed a statistical difference.3:Follow-up case: The difference was existed in efficacy after1month, butthere was no difference in the lower esophagus in changing diameter, and bothefficacy and esophageal segment diameter was different from3months to1year. POEM treatment was carried out for a short time.The recurrence can not becontrasted, but the resluts about the patients who were treated and contrastted, there was no recurrence on POEM group.Conclusion:1:Both single balloon dilation and double balloon dilatation had a significanteffect for achalasia patients, There was no significant difference in complications. But the efficacy of double-balloon dilatation for II-IV level achalasia patientswas significantly better than the patients with single balloon dilatation.the curative effect of duration of double-balloon dilatation is longer than single balloon expansion.2:The effect of the POEM treatment was superior to the double balloon dilatation, It was more effective for the higher level of difficulty swallowing, POEMtreatment was carried out for a short time, the long-term efficacy remains to beseen.