横开口与纵开口内镜下肌切开治疗贲门失驰缓疗效对比  

Clinical effects of transverse entry incision vs longitudinal entry incision during peroral endoscopic myotomy for achalasia

作　　者：李冉[1] 张瑾[2] 徐莲[1] 

机构地区：[1]山东省医学科学院第三附属医院消化内科,山东省济宁市272100 [2]山东省女子监狱医院,山东省济南市250104

出　　处：《世界华人消化杂志》2016年第26期3804-3808,共5页World Chinese Journal of Digestology

摘　　要：目的探讨横开口与纵开口内镜下肌切开治疗贲门失驰缓的临床疗效.方法选取山东省医学科学院第三附属医院2012-12/2014-12诊治的贲门失驰缓患者82例,采用随机数字表法分为两组,观察组患者41例采用横开口内镜下肌切开治疗,对照组患者41例采用纵开口内镜下肌切开治疗,比较两组患者的治疗效果.结果治疗后,两组括约肌静息压、Eckardt症状评分降低(P<0.05),食管最大宽度减小(P<0.05).观察组括约肌静息压、Eckardt症状评分、并发症发生率小于对照组(P<0.05),食管最大宽度小于对照组(P<0.05),手术时间、隧道建立时间、环形肌切开时间、切口夹闭用时、术后住院时间小于对照组(P<0.05),临床疗效好于对照组(P<0.05).结论横开口与纵开口内镜下肌切开均可用于贲门失驰缓的临床治疗,其中横开口内镜下肌切开治疗效果更佳.AIM To compare the clinical effects of transverse entry incision vs longitudinal entry incision during peroral endoscopic myotomy for achalasia.METHODS Eighty-two patients with achalasia treated at our hospital from December 2012 to December 2014 were randomly divided into two groups to undergo either transverse entry incision（observation group; n = 41） or longitudinal entry incision（control group; n = 41） during peroral endoscopic myotomy for achalasia. Therapeutic effects were compared between the two groups. RESULTS After treatment, sphincter resting pressure and Eckardt symptom score were signifi cantly reduced in both groups（P 0.05）, while the maximum width of the esophagus was significantly decreased（P 0.05）. Sphincter resting pressure, Eckardt symptom score, and complication rate in the observation group were significantly lower than those of the control group（P 0.05）, while the maximum width of the esophagus was significantly smaller than that of the control group（P 0.05）. Operative time, tunnel establishment time, circular muscle incision time, incision clipping time, and postoperative hospitalization time in the observation group were significantly shorter than those of the control group（P 0.05）. Clinical effi cacy in the observation group was signifi cantly better than that of the control group（P 0.05）.CONCLUSION Transverse entry incision has better clinical effects than longitudinal entry incision during peroral endoscopic myotomy for achalasia.

关 键 词：横开口 纵开口 内镜 贲门失驰缓 

分 类 号：R656.6[医药卫生—外科学]