经口内镜下肌切开术治疗贲门失弛缓症的疗效分析

发布时间：2019-05-21 19:11

【摘要】：目的探讨经口内镜下肌切开术治疗贲门失弛缓症的临床疗效及安全性。方法回顾性分析本院2011年1月-2012年5月本院收治的13例贲门失弛缓症患者的临床资料,均采用经口内镜下肌切开术治疗。分析手术完成情况、食管动力学指标变化、并发症及随访情况。结果手术成功率为100%,术后第4天所有患者均顺利进行流质饮食,吞咽困难较术前明显缓解。术后第3天患者食管下端括约肌静息压及4 s完全松弛压均较术前显著降低。术中及术后均未发现气胸、发热、严重出血等患者。所有患者均获得12个月的随访,吞咽困难、呕吐及胸骨后疼痛症状消失。复查胃镜显示食管创面愈合良好,贲门口明显扩大;消化道碘油造影显示食管腔较术前显著缩小。结论经口内镜下肌切开术可在短期内有效降低贲门失弛缓症患者食管下端括约肌静息压及括约肌4 s完全松弛压,缓解吞咽困难、胸骨后疼痛等症状,且并发症发生率低,安全而有效。
[Abstract]:Objective to investigate the clinical efficacy and safety of endoscopic myotomy in the treatment of achalasia. Methods the clinical data of 13 patients with achalasia treated in our hospital from January 2011 to May 2012 were analyzed retrospectively. all of them were treated with endoscopic myotomy. The completion of operation, changes of esophageal motility, complications and follow-up were analyzed. Results the success rate of the operation was 100%. On the 4th day after operation, all the patients underwent fluid diet smoothly, and the dysphagia was obviously alleviated compared with that before operation. On the 3rd day after operation, the resting pressure of lower esophageal sphincter and the complete relaxation pressure of 4 s were significantly lower than those before operation. No pneumothorax, fever, severe bleeding and so on were found during and after operation. All patients were followed up for 12 months, dysphagia, vomiting and retrosternal pain disappeared. Gastroscopy showed that the esophageal wound healed well and the cardiac entrance was significantly enlarged, and the esophageal cavity was significantly smaller than that before operation. Conclusion Endoscopic myotomy can effectively reduce the resting pressure of lower esophageal sphincter and complete relaxation pressure of sphincter in patients with achalasia in a short period of time, relieve dysphagia, retrosternal pain and other symptoms, and the incidence of complications is low. Safe and effective.
【作者单位】：东南大学医学院附属江阴医院消化科;
【基金】：中国高校医学期刊临床专项资金(11321190)
【分类号】：R571

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