经口内镜下肌切开术治疗贲门失弛缓症的临床疗效

Clinical Efficacy of Oral Endoscopic Myotomy for Achalasia of Cardia

目的探讨经口内镜下肌切开术(POEM)治疗贲门失弛缓症(AC)的疗效及安全性。方法回顾性分析2016年1月~2018年9月在我院接受POEM治疗的18例AC患者的临床资料,比较手术前后临床症状评分系统(Eckardt)评分、体重变化、影像学检查结果、手术相关并发症。结果手术成功率100.00%,平均手术时间(45.40±9.20)min;术后体重及临床症状评分均较术前改善,差异有统计学意义(P<0.05);术后3例患者出现胸骨后疼痛,2例皮下气肿,1例气胸及发热,经对症处理后并发症均缓解。结论经口内镜下肌切开术治疗贲门失弛缓症疗效确切,安全性高,能快速缓解患者症状,但远期效果有待进一步观察评估。

Objective To investigate the efficacy and safety of oral endoscopic myotomy(POEM)in treating achalasia of cardia(AC).Methods The clinical data of 18 AC patients who were treated with POEM in our hospital from January 2016 to September 2018 were retrospectively analyzed,and the clinical symptom score system(Eckardt)score,weight change,imaging results,and surgical correlation complications were compared before and after surgery.Results The operation success rate was 100.00%,and the average operation time was(45.40±9.20)min.The postoperative weight and clinical symptom scores were improved compared with preoperative ones,the difference was statistically significant(P<0.05).Postoperative sternal pain occurred in 3 patients.2 cases of subcutaneous emphysema,1 case of pneumothorax and fever,complications were relieved after symptomatic treatment.Conclusion Oral endoscopic myotomy is effective in treating achalasia of cardia with high safety,and can quickly relieve the symptoms of patients,but the long-term effect needs further observation and evaluation.