贲门失弛缓症的研究进展

Recent progress in treatment of achalasia

贲门失弛缓症是一种罕见的原发性食管动力障碍性疾病,以食管下段括约肌的松弛功能受损,食管蠕动波减少或消失,食管同步收缩为特征.由于本病的发病机制仍不明确,现有的治疗方式主要以缓解由食管下段括约肌引起的功能性梗阻为目的,同时保持降低食管下段括约肌压力与预防发生胃食管返流性疾病之间的平衡.本病的治疗方式包括药物治疗,介入治疗,手术治疗和中医整脊疗法.本文就贲门失弛缓症的最新治疗进展作一综述,重点讨论贲门失弛缓症现有的主要治疗方式包括气囊扩张术,Heller肌切开术及经口内镜下肌切开术(per-oral endoscopic myotomy,POEM)的进展.

Achalasia is a rare primary esophageal motility disorder characterized by impaired relaxation of the lower esophageal sphincter,absent or decreased esophageal peristaltic waves and synchronous contractions.As the exact pathogenesis of the disease remains unclear,treatment options focus on the alleviation of the functional obstruction caused by lower esophageal sphincter and prevention of gastroesophageal reflux disease at the same time.Treatment modalities include pharmacological therapy,interventional therapy,surgical treatment and spinal rotation massage.This article reviews the latest progress in treatment of achalasia,with particular emphasis on the evolution of main treatments which include endoscopic pneumatic dilation,Heller myotomy and per-oral endoscopic myotomy（POEM）.