POEM治疗贲门失迟缓症7例  

Peroral endoscopic myotomy for treatment of achalasia cardia: Our experience with 7 cases

作　　者：刘琳[1] 段树全 孟宪梅[1] 党彤[1] 徐美东[3] 

机构地区：[1]内蒙古科技大学包头医学院第二附属医院内蒙古消化病研究所,内蒙古自治区包头市014030 [2]包头肿瘤医院腹部外科,内蒙古自治区包头市014030 [3]复旦大学附属中山医院普外科,上海市200032

出　　处：《世界华人消化杂志》2013年第28期2994-2998,共5页World Chinese Journal of Digestology

摘　　要：目的:探讨经口内镜下肌切开术(peroral endoscopic myotomy,POEM)治疗贲门失弛缓症(achalasia of cardia,AC)的临床疗效.方法:研究2011-03-16/2013-05-30确诊为AC并接受POEM治疗的7例患者的临床资料,患者男5例,女2例,年龄20-48岁,平均30.4岁,病程持续时间2-15年.POEM主要步骤:食管黏膜层切开;分离黏膜下层,建立黏膜下隧道;胃镜直视下切开环形肌;金属夹关闭黏膜层切口.结果:7例患者均成功接受POEM手术,手术时间55-180 min,平均:114 min,环形肌切开长度8-11 cm,平均9.2 cm,2例行全层肌切开.隧道切开长度10-13 cm,平均11.7 cm,术后随访1年,5例吞咽困难均明显得到解除,2例效果不明显.结论:POEM治疗AC短期疗效确切,可以迅速缓解患者吞咽困难,但其长期疗效及远期并发症仍有待随访观察.AIM： To evaluate the clinical efficacy of peroral endoscopic myotomy （POEM） in the treatment of achalasia cardia （AC）. METHODS： The clinical data for 7 patients who were diagnosed with AC and received POEM at our center from May 16, 2011 to May 30, 2013 were reviewed. They ranged in age from 20 to 48 years old, with a mean value of 30.4 years. The disease courses lasted for 2 to 15 years. Key procedures of POEM were esophageal mucosal incision, submucosal tunneling by endoscopicsubmucosal dissection, the circular muscle and using hemostatic clips endoscopic myotomy of closure of mucosal entry RESULTS： POEM was successful in all the pa- tients. Mean operation time was 114 min （range, 55-180 min）. Mean submucosal tunneling length was 11.7 cm （range, 10-13 cm）. Mean length of endoscopic myotomy of the circular muscle was 9.2 cm （range, 8-11 cm）. Two cases underwent full-thickness myotomy. Patients were followed for one year. Five cases of dysphagia were cured, and no obvious effect was observed in two cases. CONCLUSION： POEM has good short-term ef- ficacy in relieving dysphagia. Further observa- tion is needed to evaluate long-term efficacy and complications.

关 键 词：贲门失弛缓症 肌切开术 POEM 

分 类 号：R571[医药卫生—消化系统]