经口内镜下肌切开术与经胸Heller术治疗贲门失弛缓症的临床疗效对比

发布时间：2018-02-05 01:06

本文关键词： 贲门失弛缓症 POEM术 Heller术临床疗效　出处：《中国内镜杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的对比分析贲门失弛缓患者经口内镜下肌切开术(POEM)与经胸食管贲门部黏膜外肌层切开手术(即Heller术)的临床疗效及安全性。方法回顾性研究2012年1月-2014年10月该院78例确诊为贲门失弛缓症患者。其中,接受POEM术患者为42例,接受Heller术患者36例,观察并对比两组患者术后症状缓解情况、食管下段括约肌(LES)静息压力、Eckardt评分、术中和术后并发症发生率、手术时长、住院时间及住院费用等。结果两组患者术后均获得明显的临床缓解,POEM组患者的并发症发生率、Eckardt评分及LES静息压力和Heller术组相比差异无统计学意义(P0.05)。而POEM组患者的手术耗时、住院时长及住院费用均明显低于Heller术组(P0.05)。结论 POEM作为一种近期疗效显著的内镜微创手术方式,与外科手术疗效相当,对患者造成的创伤小,痛苦小,使患者耐受性好,住院时间及住院费用减少,值得推广。
[Abstract]:Objective to compare and analyze the transoral endoscopic myotomy (Poemm) and transthoracic esophagogastric cardia incision (Heller) in patients with achalasia of the cardia. Methods from January 2012 to October 2014, 78 patients with achalasia were retrospectively studied. POEM was performed in 42 patients and Heller in 36 patients. The relief of symptoms and rest pressure of lower esophageal sphincter were observed and compared between the two groups. Eckardt score, incidence of intraoperative and postoperative complications, length of operation, length of stay and cost of hospitalization. Incidence of complications in POEM group. There was no significant difference in Eckardt score and LES resting pressure between the Heller group and the Heller group (P 0.05). However, the duration of operation in the POEM group was less than that in the POEM group. The length of stay in hospital and the cost of hospitalization were significantly lower than those in Heller group. Conclusion POEM is an effective endoscopic minimally invasive operation, which is comparable to that of surgery. It is worth popularizing that the patients have less trauma and less pain, so they have better tolerance, less hospitalization time and less hospitalization cost.
【作者单位】：河南省人民医院消化内科;郑州大学第一附属医院麻醉科;
【基金】：2016年河南省卫计委科技攻关项目(No:201602225)
【分类号】：R655.4
【正文快照】： 贲门失弛缓症是一种原因不明的原发性食管动力障碍性疾病,以食管体部蠕动缺失和食管下段括约肌(1ower esophageal sphincter,LES)松弛不全为特点。本病的发病率约为1/100 000,患者常出现吞咽困难症状,严重影响生活质量,且不易治愈[1]。对于贲门失弛缓症确诊后如何选择最佳的初

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