贲门失弛缓症临床分析

发布时间：2018-08-18 21:25

【摘要】：目的探讨宁夏医科大学总院10年贲门失弛缓症患者的临床特征,为本病的诊断及治疗提供更多的依据。方法收集2006年1月至2015年12月宁夏医科大学总医院收治的156例贲门失弛缓症患者的临床资料,回顾性分析其一般资料、临床表现、影像学表现及治疗方法等。结果1、近10年贲门失弛缓症住院患者共收治156例,2006年收住9例,2015年升至16例,增加约1.78倍。2、156例贲门失弛缓症患者,其中男性63例,女性93例,男女比例1:1.48,平均确诊年龄39.81±15.86岁,平均病程7.03±6.47年。3、本组贲门失弛缓症患者的临床表现为吞咽困难(100%)、返流(92.31%)、胸骨后疼痛(42.31%)、体重下降(30.77%)、干咳(6.41%)、贫血(3.85%)。4、本组贲门失弛缓症患者上消化道钡餐造影表现为贲门狭窄(100%)、食管扩张(100%)、贲门鸟嘴征(97.44%)、食物潴留(48.08%)、食管炎(3.21%)、食管憩室(1.92%);胃镜表现为贲门紧闭(100%)、食管扩张(84.62%)、食物潴留(49.36%)、食管黏膜充血水肿(35.90%)、霉菌性食管炎(2.56%)、食管憩室(2.56%)。5、本组患者接受的治疗方式有球囊扩张术(43.58%)、支架植入术(30.76%)、经口内镜下肌切开术(10.29%)、外科手术(8.33%)、注射肉毒素(2.56%)、口服药物(4.49%)。16例经口内镜下肌切开术治疗患者,术后Eckardt评分较术前明显降低(P0.05),术后随访6月,有效缓解率为92.85%。结论1、贲门失弛缓症发病人群以中青年为主;2、贲门失弛缓症患者以吞咽困难、反流为主要临床表现;3、上消化道钡餐造影及胃镜均可用于诊断贲门失弛缓症;4、目前治疗贲门失弛缓症的方法有多种,我院现以经口内镜下肌切开术为主,疗效可靠。
[Abstract]:Objective to investigate the clinical features of achalasia in 10 years in General Hospital of Ningxia Medical University, and to provide more evidence for diagnosis and treatment of achalasia. Methods the clinical data of 156 patients with achalasia were collected from January 2006 to December 2015 in the General Hospital of Ningxia Medical University. The general data, clinical manifestations, imaging manifestations and treatment methods were analyzed retrospectively. Results 1.A total of 156 achalasia inpatients were admitted in recent 10 years, 9 in 2006, 16 in 2015, an increase of 1.78 times. 2156 cases of achalasia, including 63 males and 93 females, the ratio of male to female was 1: 1.48, the average age of diagnosis was 39.81 卤15.86 years. The mean course of disease was 7.03 卤6.47 years. The clinical manifestations of achalasia were dysphagia (100%), reflux (92.31%), retrosternal pain (42.31%), weight loss (30.77%), dry cough (6.41%), anemia (3.85%). Esophageal stricture (100%), esophageal dilatation (100%), cardia mouth sign (97.44%), food retention (48.08%), esophagitis (3.21%), esophageal diverticulum (1.92%), gastroscope (100%), esophageal dilatation (84.62%), food retention (49.36%), esophageal mucosal congestion and edema (35.90%), fungal esophagitis (2.56%), esophageal diverticulum (2.56%) .5. The patients received balloon dilatation (43.58%), stenting (30.76%), endoscopic myotomy (10.29%), surgery (8.33%), botulinum toxin injection (2.56%), oral medication (4.49%). The postoperative Eckardt score was significantly lower than that before operation (P0.05), and the effective remission rate was 92.85 after 6 months follow-up. Conclusions 1. The incidence of achalasia was mainly in the young and middle-aged, and the patients with achalasia had difficulty in swallowing. Reflux is the main clinical manifestation. Upper gastrointestinal barium meal and gastroscopy can be used to diagnose achalasia. There are many methods to treat achalasia.
【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R571

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