腹腔镜下改良Heller手术对贲门失迟缓症吞咽障碍的疗效  

Effect of laparoscopic modified Heller surgery on dysphagia of esophageal achalasia

作　　者：张云峰[1] 于磊[1] 柯冀[1] Zhang Yunfeng;Yu Lei;Ke Ji(Department of Thoracic Surgery,Beijing Tongren Hospital Capital Medical University,Beijing 100730,China)

机构地区：[1]首都医科大学附属北京同仁医院胸外科,100730

出　　处：《北京医学》2020年第5期407-409,共3页Beijing Medical Journal

摘　　要：目的评价腹腔镜下改良Heller手术对贲门失迟缓症患者吞咽障碍的疗效。方法选取2013年1月至2018年1月首都医科大学附属北京同仁医院收治的贲门失弛缓症患者,其中52例行腹腔镜下改良Heller手术(手术组),48例行食管球囊扩张术(扩张组),比较两组术后吞咽障碍评分及疗效。结果治疗后3个月,扩张组吞咽障碍评分与手术组比较,差异无统计学意义[(9.12±0.24)分比(9.18±0.41)分,P>0.05];治疗后12个月时,手术组评分为(8.79±0.18)分,扩张组评分为(5.25±0.28)分,差异有统计学意义(P<0.05);18个月时,手术组评分为(8.68±0.29)分,基本保持恒定,而扩张组则出现明显下降趋势,仅为(3.42±0.38)分,差异有统计学意义(P<0.05)。就远期疗效而言,手术组总有效率明显优于扩张组(92.31%比52.08%,P<0.05)。结论腹腔镜下改良Heller手术微创、美观,可有效改善贲门失迟缓症患者的吞咽障碍,远期疗效确切。Objective To analyze the long-term effect of dysphagia in patients with esophageal achalasia who had undergone laparoscopic modified Heller operation.Methods A retrospective analysis of patients with esophageal achalasia from January 2013 to January 2018 was carried out.Fifty-two patients underwent laparoscopic modified Heller operation(operation group),48 patients underwent simple esophageal balloon dilatation(dilation group).Videofluorocopic swallowing study(VFSS)scores and total effective rates were compared between the two groups.Results After three months and six months of treatment,there were little difference in VFSS between the two groups(P>0.05).After 12 and 18 months of treatment,VFSS in the operation group was significant higher than that in the dilation group[(8.79±0.18)vs.(5.25±0.28),P<0.05;(8.68±0.29)vs.(3.42±0.38),P<0.05].Total effective rate of the operation group was superior to the dilatation group[92.31%vs.52.08%,P<0.05].Conclusions The laparoscopic modified Heller operation is minimally invasive,and it can effectively relieve dysphagia of the patients with esophageal achalasia,and its long-term efficacy is reliable.

关 键 词：贲门失迟缓症 吞咽障碍 食管下段贲门肌层切开术 

分 类 号：R655.4[医药卫生—外科学]