经口内镜下肌切开术对贲门失弛缓症患者生命质量影响的多中心研究

Effect of peroral endoscopic myotomy on the quality of life in patients with achalasia： a multicenter clinical study

目的分析贲门失弛缓症患者生命质量状况，并评估经口内镜下肌切开术（POEM）对其的影响。方法采用健康调查简表（SF-36）评估627例贲门失弛缓症患者POEM治疗前后的生命质量，并与627名健康对照者进行比较。两组均数比较采用t检验。结果贲门失弛缓症患者POEM术前Eckardt评分为7．80±1．20，术后6个月为1．08±0．23，差异有统计学意义（t=18．232，P〈0．05），临床症状较术前明显好转。贲门失弛缓组SF-36各维度得分均低于健康对照组，贲门失弛缓症患者POEM术后SF-36各维度评分均较术前明显升高，差异均有统计学意义（P均〈o．05）。结论贲门失弛缓症患者的生命质量普遍较低，并受多种因素影响，POEM能明显提高患者的生命质量。

Objective To evaluate the life quality in patients with achalasia, and to assess the effect of peroral endoscopic myotomy （POEM） on it. Methods MOS Item Short Health Survey （SF-36） was used to assess the quality of life in 627 patients with achalasia before and after POEM treatment, and which was also compared with that of 627 healthy control subjects. Means between two groups were compared by t test. Results Before POEM, Eckardt score of patients with achalasia was 7.80 ± 1.20, which was 1.08±0.2a at six months after operation. Compared with that before operation, the clinical symptoms were significantly improved, and the difference was statistically significant （t = 18. 232, P〈 0.05）. The score of each item of SF-36 in patient group was lower than that of healthy control group （all P〈0.05）. After POEM operation, the score of each item of SF-36 was significantly higher than that before operation, and the differences were statistically signficant （all P〈0.05）. Conclusions The quality of life in patients with achalasia was poor and affected by many factors. POEM can remarkably improve the quality of life in patients with aehalasia.