经口内镜肌切开术治疗弥漫性食管痉挛近期疗效和安全性分析  

作　　者：郑华琴[1] 李华铭[1] 程晓妹[1] 葛秀华 冯婕 

机构地区：[1]浙江省杭州市第三人民医院,310009

出　　处：《浙江临床医学》2020年第1期94-96,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨经口内镜肌切开术治疗弥漫性食管痉挛近期疗效和安全性.方法选取2011年1月至2017年6月弥漫性食管痉挛患者68例,随机分为观察组与对照组(各34例).对照组采用Heller手术治疗,观察组采用经口内镜肌切开术治疗,比较两组患者手术情况、住院时间、术后并发症发生情况、临床症状缓解情况及手术前、术后1年食管括约肌压力.结果观察组术中出血量、手术时间及住院时间均少于或短于对照组(P<0.05);术后1年两组患者合并吞咽困难、胸痛、反酸等症状人数比例均比治疗前减少(P<0.05),且观察组各症状缓解情况优于对照组(P<0.05);术后1年两组患者食管括约肌压力均低于术前(P<0.05),且观察组食管括约肌压力低于对照组(P<0.05);两组患者并发症发生率(14.71%VS.11.76%)比较,差异无统计学意义(χ^2=0.128,P=0.720).结论经口内镜肌切开术治疗弥漫性食管痉挛临床疗效显著,可有效改善患者相关症状,降低食管括约肌压力,且无严重手术并发症发生.Objective To investigate the short-term efficacy and safety of peroral endoscopic myotomy for diffuse esophageal spasm.Methods A total of 68 patients with diffuse esophageal spasm treated in our hospital from January 2011 to June 2017 were selected and equally divided into two groups,each with 34 cases.The control group was treated with Heller surgery,while the observation group received the peroral endoscopic myotomy.Then the operative status,length of hospital stay,postoperative complications,clinical symptom relief,and preoperative and postoperative one-year esophageal sphincter pressure were compared between the two groups.Results The intraoperative blood loss,operative time and hospital stay in the observation group were less than or shorter than those in the control group(P<0.05).The symptoms including dysphagia,chest pain and acid regurgitation were relieved in both groups at the postoperative 1yr(P<0.05),and were better in the observation group than in the control group(P<0.05).The postoperative 1yr esophageal sphincter pressure were decreased in both groups(P<0.05),and were lower in the observation group than in the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(14.71%VS 11.76%,χ^2=0.128,P=0.720).Conclusion The application of the peroral endoscopic myotomy can effectively ameliorate the related symptoms and reduce the esophageal sphincter pressure for patients with diffuse esophageal spasm,and it also has no serious surgical complications.

关 键 词：经口内镜肌切开术 弥漫性食管痉挛 近期疗效 安全性分析 

分 类 号：R73[医药卫生—肿瘤]