贲门失弛缓症经口内镜下肌切开术手术效果的影响因素分析  

Analysis of the factors affecting the outcomes of POEM for achalasia

作　　者：李明阳[1] 刘宁[2,1] 陈倩倩[1] 令狐恩强[1] 卢忠生[1] 柴宁莉[1] 李闻[1] Li Mingyang Liu Ning Chen Qianqian Linghu Enqiang Lu Zhongsheng Chai Ningli Li Wen(Department of Gastroenterology, Chinese PLA General Hospital, Beijing 100853, China Department of Gastroenterology, Liuzhou People＇s Hospital, Liuzhou Guangxi 545006, China)

机构地区：[1]解放军总医院消化内科,北京100853 [2]柳州市人民医院消化内科,广西545006

出　　处：《中华胃肠内镜电子杂志》2016年第3期99-102,共4页Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition)

摘　　要：目的观察不同因素对经口内镜下肌切开术(peroral endoscopic myotomy,POEM)治疗效果的影响。方法回顾性分析2014年11月至2015年5月解放军总医院消化科诊断为贲门失弛缓症(achalasia,AC)并接受POEM治疗的42例患者的临床资料,总结并分析影响POEM效果的因素。结果术前Eckardt评分、年龄均与症状缓解呈负相关;芝加哥分型Ⅱ型及LingⅠ型患者疗效最佳;初治较经治患者疗效好;短隧道及标准隧道、渐进式全层切开、肌切开长度等因素对POEM疗效无显著影响。结论术前Eckardt评分(<6分)、年龄(<60岁)、芝加哥分型Ⅱ型、Ling分型Ⅰ型及初治的患者为预后良好的预测指标,手术方式的选择需个体化,不作为预测指标。Objective To observe the multiple influencing factors affecting the outcomes of peroral endoscopic myotomy（ POEM）. Methods The clinical data of 42 cases of achalasia（ AC） who received POEM were retrospectively analyzed. Results Post-operation of Eckardt score and age were negatively correlated with symptoms. Patients classified as Chicago classification of type Ⅱ and Ling classification of typeⅠhad the best outcome. Treatment-naive patients had better outcome than treatment-experienced ones.Short and standard tunnel,graduate incision of full thickness and length of cutting had no influence of outcomes. Conclusions There were some indexes predicting good prognosis,such as,post-operation of Eckardt score（ 6 scores）,age（ 60 years old）,Chicago classification of typeⅡ,Ling classification of typeⅠ and treatment-naive patients. Surgical options would be personalized and could not be indexes of prognosis.

关 键 词：贲门失弛缓 经口内镜下肌切开术 影响因素 手术效果 

分 类 号：R655.4[医药卫生—外科学]