目的探讨经胃镜球囊扩张治疗贲门失弛缓症(AC)的临床效果。方法将90例确诊的AC患者随机分为两组,扩张组(n=45例)经胃镜球囊扩张(Endoscopic balloon pneumatic dilation,EPD)治疗,手术组(n=45例)行外科手术治疗。术后1、3、6、9、12个月各随访1次,此后每年随访1次,对两组的疗效、随访资料进行对比分析。结果两组有效率、并发症发生率,扩张组为93.3%和11.1%,手术组为95.6%和13.3%;扩张组、手术组累积复发率分别为24.4%和17.7%;两组比较差异均无统计学意义(P>0.05)。每例次平均住院日和住院费,扩张组分别为6.1d和4311.5元,手术组为17.8d和11972.1元,两组比较差异均有统计学意义(P<0.05)。结论 EPD治疗AC,因其疗效确切、安全性高、操作简单且住院时间和费用显著低于手术治疗,是治疗AC较为理想的首选和主要方法。 Objective To investigate the clinical effect of endoscopic balloon dilatation on achalasia (AC). Methods Ninety patients with AC were randomly divided into two groups. The patients in the expansion group (n = 45) underwent endoscopic balloon pneumatic dilation (EPD). The operation group (n = 45) underwent surgical treatment. The patients were followed up 1, 3, 6, 9 and 12 months after operation, and were followed up once every year thereafter. The curative effect and follow-up data of the two groups were compared and analyzed. Results The effective rate and complication rate in the two groups were 93.3% and 11.1% in the expansion group and 95.6% and 13.3% in the operation group. The cumulative recurrence rates in the expansion group and the operation group were 24.4% and 17.7% No statistical significance (P> 0.05). The average length of hospital stay and hospitalization for each case were 6.1d and 4311.5 yuan in the expansion group and 17.8 days and 11972.1 yuan in the operation group, respectively. There was significant difference between the two groups (P <0.05). Conclusion EPD is an ideal and preferred method for the treatment of AC due to its definite curative effect, high safety, easy operation and significantly lower hospitalization time and cost.