经口内镜下肌切开术治疗贲门失弛缓症的初步研究 （附27 例报告）

Primary research of peroral endoscopic myotomy for treatment in 27 cases esophageal achalasia of cardia

摘要:

目的 探讨经口内镜下肌切开术（POEM）治疗贲门失弛缓症（AC）的疗效。方法 收集2014 年5 月-2016 年3 月遵义医学院附属医院消化内科收住入院的27 例确诊为AC 的患者，并实施POEM 术， 总结手术完成情况、手术前后临床症状、食管测压、术后并发症及随访过程等资料。结果 27 例患者行 POEM 治疗的成功率为100.0%，1 例患者发现皮下气肿，1 例患者发现少量气胸，行POEM 患者中随访症状 较前明显改善，食管测压较前亦有显著变化（P <0.05）。结论 POEM 治疗AC 的短期疗效肯定，术后能够明 显缓解吞咽困难等症，但其长期疗效及远期并发症仍有待进一步随访和观察。

Abstract:

Objective To investigate the clinical effects of peroral endoscopic myotomy (POEM) in the treatment of achalasia of cardia. Methods Clinical data of 27 cases who were diagnosed with achalasia of cardia recived POEM from May 2014 to March 2016 were collected retrospectively. The surgical results, before and after POEM, parameters measured by esophageal manometry and complications after POEM and during follow-up were analyzed. Results POEM were successful 100.0% in the 27 patients. There was 1 case of subcutaneous emphysema, 1 case of aeropleura symptoms were significantly improved in all patients who had successful POEM; parameters measured by esophageal manometry were also improved obviously (P < 0.05). Conclusion POEM has appreciable short-term effects in the treatment for achalasia of cardia, and it can be relieve dysphagia and other adverse symptoms in postoperation, but the long-term efficacy and complications need further follow-up observations.