贲门失弛症患者手术前后食管功能分析

Evaluation of pre and post operational esophageal manometric findings with achalasia

目的观察贲门失弛症患者的食管动力学功能改变的特点及经腹行贲门肌层切开术的手术疗效。方法对２３例术前病例和１７例术后病例进行食管动力学和ｐＨ检查，其中１１例作自身手术前后对照，１０例术后病例作食管腔内２４小时ｐＨ监测。结果食管下括约肌的静息压力明显高于正常；食管下括约肌在吞咽时不能充分松弛；食管腔内的静息压明显高于正常；食管体均为同步收缩波，无正常的蠕动波。术后异常胃食管反流引起反流性食管炎的发生率为２２２％。结论食管功能手术前后资料提示，经腹做贲门肌层切开的手术方法简单易行，缓解症状疗效好。

Objective To evaluate the manometric feature of pre and post operation with achalasia and the result of surgical myotomy through abdominal incision. Methods The manometric studies were performed in 23 pre and 11 post operational patients,including 11 patients who received both pre and post operational studies.24 hour pH monitoring was performed in 11 after surgical myotomy. Results Achalasia, a motor disorder of the esophageal body, and hypertension of the resting LES impaired relaxation.The incidence of reflux was 22.2%. Conclusions Surgical myotomy through abdominal incision is an effective procedure.It is necassary to avoid LES incompetence or reflux esophagitis.