经口内镜下肌切开术治疗贲门失弛缓症患者的效果  

Effects of peoral endoscopic myotomy in treatment of patients with achalasia

作　　者：苗慧 MIAO Hui(Endoscopy Room of the Third People’s Hospital of Liaoyang,Liaoyang 111000 Liaoning,China)

机构地区：[1]辽阳市第三人民医院腔镜室,辽宁辽阳111000

出　　处：《中国民康医学》2021年第17期9-11,共3页Medical Journal of Chinese People’s Health

摘　　要：目的:观察经口内镜下肌切开术(POEM)治疗贲门失弛缓症(AC)患者的效果。方法:选取68例AC患者为研究对象,按照随机数字表法分为研究组与对照组各34例。对照组采用Heller术治疗,研究组采用POEM术治疗,比较两组手术前后食管管腔扩张直径、食管下括约肌(LES)静息压、LES松弛率、AC临床症状评分系统(Eckardt)评分和胃食管反流病问卷(GerdQ)评分,以及并发症发生率。结果:术后1个月,两组LES静息压均低于术前,且研究组明显低于对照组,差异有统计学意义(P<0.05);手术前后,两组食管管腔扩张直径和LES松弛率比较,差异均无统计学意义(P>0.05);术后1、6、12个月,两组Eckardt和GerdQ评分均低于术前,且研究组低于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:POEM术治疗AC患者可降低术后LES静息压、Eckardt评分和GerdQ评分,效果优于Heller术。Objective:To observe effect of peoral endoscopic myotomy(POEM)in treatment of patients with achalasia(AC).Methods:68 AC patients were selected as the research objects,and were divided into study group and control group according to the random number table method,34 cases in each group.The control group was treated with Heller surgery,while the study group was treated with POEM surgery.The esophageal lumen dilation diameter,the lower esophageal sphincter(LES)resting pressure,the LES relaxation rate,the AC clinical symptom scoring system(Eckardt)score,the gastroesophageal reflux questionnaire(GerdQ)score,and the incidence of complications were compared between the two groups before and after the surgery.Results:One month after the surgery,the LES resting pressures of the two groups were lower than those before the surgery;that of the study group was significantly lower than that of the control group;and the differences were statistically significant(P<0.05).Before and after the surgery,there were no significant differences in the esophageal lumen dilation diameter and the LES relaxation rate between the two groups(P>0.05).The Eckardt and GerdQ scores of the two groups were lower than those before the surgery 1 month,6 months,and 12 month after the surgery;those of the study group were lower than those of the control group;and the differences were statistically significant(P<0.05).Further,there was no statistically significant difference in the incidence of complications between the two groups(P>0.05).Conclusions:POEM in the treatment of the AC patients can reduce the postoperative LES resting pressure,the Eckardt score and the GerdQ score.Moreover,it is superior to Heller surgery.

关 键 词：贲门失迟缓症 经口内镜下肌切开术 食管下括约肌静息压 Eckardt评分 GerdQ评分 

分 类 号：R65[医药卫生—外科学]