经口内镜下肌切开术治疗贲门失弛缓症12例  

Peroral endoscopic myotomy for treatment of esophageal achalasia: Analysis of 12 cases

作　　者：高志强[1] 黄志刚[1] 任辉[1] 

机构地区：[1]宁波市医疗中心李惠利医院消化内科,浙江省宁波市315040

出　　处：《世界华人消化杂志》2014年第21期3100-3105,共6页World Chinese Journal of Digestology

摘　　要：目的:探讨贲门失弛缓症(esophageal achalasia,EA)的诊断及经口内镜下肌切开术(peroral endoscopic myotomy,POEM)治疗贲门失弛缓症的疗效.方法:收集2012-11/2014-01宁波市医疗中心李惠利医院消化内科收住入院的12例确诊为贲门失弛缓症患者,并实施POEM术.总结手术完成情况、手术前后食管测压情况、术后并发症及随访过程.结果:12例行POEM治疗患者中10例成功完成,1例出现皮下气肿,1例出现纵膈气肿和皮下气肿及胸腔积液,1例发生消化系出血.成功完成的10例POEM患者中随访症状较前明显改善,食管测压较前亦有显著变化.结论:食管测压是诊断贲门失弛缓症的金标准.POEM治疗贲门失弛缓症短期疗效肯定,但其长期疗效及远期并发症仍有待进一步随访和观察.AIM： To investigate the diagnostic criteria for esophageal achalasia and evaluate the clinical ef- fects of peroral endoscopic myotomy （POEM） in the treatment of esophageal achalasia. METHODS： The clinical date of 12 patients who were diagnosed with esophageal achalasia and re- cived POEM in the Ningbo Medical Center, Lihuili Hostpial between November 2012 and January 2014 were reviewed retrospectively. The surgical results, parameters measured by esophageal ma- nometry before and after POEM, and complications after POEM and during follow-up were analyzed. RESULTS： POEM were successful in 10 of the 12 patients. There were 1 case of subcutaneous emphysema, 1 case of pneumomediastinum, subcutaneous emphysema and pleural effusion, and 1 case of hemorrhage of the digestive tract.Symptoms were significantly improved in 10 patients who had successful POEM; parameters measured by esophageal manometry were also improved obviously. CONCLUSION： Esophageal manometry is the gold standard for the diagnosis of achalasia. POEM has appreciable short-term effects in the treatment of achalasia, but the long-term effi- cacy and complications need further follow-up observations.

关 键 词：贲门失弛缓症 经口内镜下肌切开术 高分辨率食管测压 

分 类 号：R655.4[医药卫生—外科学]