经口内镜下肌切开术后食管隧道切口愈合情况的临床研究  

Clinic investigation of healing of esophageal tunnel incision after peroral endoscopic myotomy

作　　者：令狐恩强[1] 秦治初[1] 孟曼[1] 李志群[1] 张游[1] 李惠凯[1] 

机构地区：[1]中国人民解放军总医院消化科,北京100853

出　　处：《中华腔镜外科杂志（电子版）》2013年第1期42-44,共3页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的研究经口内镜下肌切开术后食管隧道切口愈合情况。方法回顾性分析2012年5月至12月间成功行经口内镜下肌切开术(POEM)治疗的30例贲门失弛缓症患者的术后内镜复查资料。30例患者男17例,女13例。年龄16～58岁,平均38.5岁。术后常规使用抑酸药,分别于术后1周、2周、1个月及3个月进行内镜复查,统计钛夹脱落情况及食管隧道切口愈合情况。结果 30例患者共用232个钛夹,术后1周、2周、1个月及3个月钛夹脱落率分别为16.8%(39/232)、41.4%(96/232)、65.1%(151/232)及83.2%(193/232)。1周、2周、1个月及3个月愈合率分别为20.0%(6/30)、86.7%(26/30)、96.7%(29/30)及100%。结论 POEM术后2周至1个月后食管切口大部分愈合,钛夹完全脱落则需要较长时间。Objective To investigate the healing of esophageal tunnel incision and the falling of titanium clips after peroral endoscopic myotomy ( POEM ). Methods The time of esophageal tunnel incision healing and titanium clips falling of 30 patients with achalasia using PPI ( proton pump inhibitors ) for one month after POEM were retrospectively analyzed between May to December 2012 . The follow-up time of endoscopic examination was one week , two weeks , one month and three months. Results Two hundred and thirty-two titanium clips had been used, the rate of all titanium clips falling off was 16.8 % ( 39/232 ), 41.4 % ( 96/232 ), 65.1 % ( 151/232 ) and 83.2 % ( 193/232 ) at the first week, second week, first month and third month. Moreover the rate of esophageal incision healing was 20.0 % ( 6/30 ), 86.7 %( 26/30 ), 96.7 %( 29/30 ) and 100 % . Conclusions Most of esophageal incisions after POEM will heal from two weeks to one month, but falling completely of the titanium clips will require a longer time.

关 键 词：经口内镜下肌切开术 食管隧道切口 愈合 

分 类 号：R655.4[医药卫生—外科学]