贲门失弛缓症的诊断与治疗进展

Progress of diagnosis and treatment of achalasia

贲门失弛缓症(achalasia,AC)是一种食管运动障碍性疾病,发病机制尚未明确,可导致下食管括约肌放松和蠕动功能障碍性疾病。其发生率每年5/100 000人,患病率每年8/100 000人,表现以吞咽困难为主。诊断的金标准为高分辨食管测压(high resolution manometry,HRM),其他检查方法包括内窥镜、X线钡餐造影等,其中HRM能对AC患者进行分型并评价预后。治疗AC的方法主要有药物治疗、球囊扩张术、肉毒杆菌注射及食管支架治疗等,近年来经腹腔镜贲门肌切开术(laparoscopic heller myotomy,LHM)及经口内镜下肌切开术(peroral endoscopic myotomy,POEM)得到广泛推广。现本文对AC的诊断与治疗进展作一概述。

Achalasia（ AC） is a kind of esophageal motility disorder. The pathogenesis is not clear yet,resulting in lower esophageal sphincter relaxation and motility dysfunction. The incidence rate was 5/100 000 per year,the prevalence rate was 8/100 000 per year,and performance is mainly dysphagia. The gold standard for diagnosis is high resolution manometry（ HRM）,other methods include endoscopy and X-ray barium meal. HRM can classify the AC patients and evaluate the prognosis. Treatment methods of AC mainly include drug therapy,balloon dilation,botulinum toxin injection and esophageal stent treatment. In recent years,laparoscopic heller myotomy（ LHM） and peroral endoscopic myotomy（ POEM） have be widely spread. This article would review the diagnosis and treatment of AC.