POEM治疗贲门失弛缓症临床效果分析  

Clinical analysis of POEM in the treatment of achalasia

作　　者：刘梅红 张逸强 Liu Meihong;Zhang Yiqiang(Zhumadian Central Hospital,Zhumadian 463000,Henan China)

机构地区：[1]驻马店市中心医院,河南驻马店463000

出　　处：《临床心身疾病杂志》2019年第4期144-146,共3页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨经口内镜下肌切开术治疗贲门失弛缓症患者的临床效果.方法将120例贲门失弛缓症患者根据治疗方法分为A组66例与B组54例.A组患者给予经口内镜下肌切开术治疗,B组患者给予气囊扩张治疗,比较两组患者手术前后临床Eckardt评分、食管下段括约肌压力、食管体部顺行性收缩、食管体部非协调性收缩率、食管最宽处直径及并发症发生率.结果治疗后两组临床Eckardt评分均显著低于治疗前(P<0.01),A组较B组降低更显著(P<0.01).治疗后两组食管下段括约肌压力、食管体部顺行性收缩、食管体部非协调性收缩率及食管最宽处直径均显著小于治疗前(P<0.01),A组食管下段括约肌压力及食管最宽处直径均显著小于B组(P<0.01).两组患者并发症发生率比较差异无统计学意义(P>0.05).结论经口内镜下肌切开术治疗贲门失弛缓症患者疗效显著,能显著降低患者食管下段括约肌压力,缩小食管最宽处直径,安全性高,值得推广应用.Objective To investigate the clinical effect of POEM in the treatment of achalasia.Methods Atotal of 120 patients with achalasia were divided into group A (66 cases) and group B (54 cases) according to treatment methods.Group A was treated with PO EM and group B was treated with balloon dilatation.The clinical Eckardt score,lower esophageal sphincter pressure,antegrade contraction of the esopha-g us,uncoordinated contraction of the esophageal body,diameter of the widest part of the esophagus,and complication rate were compared between the two groups.Results The clinical Eckardt scores of the two groups were significantly lower than those before treatment ( P<0.01 ),and group A was significantly lower than group B ( P<0.01).Af ter treatment,the lower esophageal sphincter pressure,esophageal anteg rade contraction,esophageal body uncoordinated contraction rate and the diameter of the widest part of the esophagus were significantly less than those before treatment ( P < 0.01 ).The lower esophageal sphincter pressure and the diameter of the widest part of the esophagus in group A were significantly smaller than those in group B ( P<0.01).There was no significant difference in the incidence of complications between the two groups ( P>0.05).Conclusion POEM in the treatment of patients with achalasia has a significant effect,it can significantly reduce the lower esophageal sphincter pressure,reduce the diameter of the widest part of the esophagus,and has high safety,which is worthy of popularization and application.

关 键 词：贲门失弛缓症经 口内镜下肌切开术 气囊扩张治疗 食管下段括约肌压力 

分 类 号：R322.43[医药卫生—人体解剖和组织胚胎学] R322.44[医药卫生—基础医学]