经口内镜下环形肌切开术治疗儿童贲门失弛缓症的远期疗效观察  

Long-term effect of peroral endoscopic myotomy on achalasia in pediatric patients

作　　者：方莹[1] 任晓侠[1] 杨洪彬[1] 刘志国[2] 周平红[3] 

机构地区：[1]西安市儿童医院消化内科,710032 [2]第四军医大学西京消化病医院 [3]上海复旦大学附属中山医院内镜中心

出　　处：《中华消化内镜杂志》2015年第8期544-548,共5页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨经口内镜下环形肌切开术（POEM）治疗儿童贲门失弛缓症（Ac）的可行性、安全性及疗效。方法对2012年1月至2014年12月西安市儿童医院及上海复旦医科大学中山医院消化内镜中心的21例儿童AC患者进行POEM治疗，观察手术相关并发症和食管反流发生情况，并对比分析治疗前后Eckardt评分和食管下段括约肌压力变化。结果21例均成功实施POEM手术，无一例出现与POEM相关的严重并发症。术后随访时间20．4个月（9～36个月），所有患者症状缓解[Eckardt评分平均分从术前的8．1分降至术后的0．8分（P〈0．01）]，食管括约肌压力明显降低[平均压从术前的30．2mmHg（1mmHg=0．133kPa）下降至术后的11．5mmHg（P〈0．01）]，食管反流总发生率为19．0％（4／21）。结论POEM用于儿童AC的治疗是安全的，并且具有较好的远期疗效。Objective To explore the feasibility, safety and the efficacy of peroral endoscopic myot- omy （POEM） for pediatric patients with achalasia. Methods A total of 21 patients （mean age 2 years, range 11 months-7 years） with AC were enrolled and underwent POEM from January 2012 to December 2014. Procedure-related complications, reflux esophagitis were observed. Eckardt score and the pressure of the lower esophageal sphincter （LES） were analysed. Results All patients underwent POEM successfully. No serious POEM-related complications were observed. During a mean follow-up period of 20. 4 months （range 9-36 months）, mean Eckardt score decreased from 8. 1 to 0. 8 after treatment （P 〈 0. 01 ）. Mean LES treatment also decreased from 30. 2 mmHg to 11.5 mmHg after the operation （ 1 mmHg =0. 133 kPa, P 〈 0. 01 ）. Reflux esophagitis developed in four patients （ 19. 0% ,4/21 ）. Conclusion POEM is safe and effective treatment for pediatric patients with achalasia.

关 键 词：贲门失弛缓症 经口内镜下环形肌切开术 小儿 

分 类 号：R726.5[医药卫生—儿科]