经口内镜下肌切开术治疗贲门失弛缓症的疗效及安全性分析

Clinical Efficacy and Safety of POEM in the Treatment of Achalasia

目的分析贲门失弛缓症患者经口内镜下肌切开术(POEM)的预后及安全性。方法收集2013年1月—2015年7月期间我院20例行POEM术治疗贲门失弛缓症并且随访满36个月患者的临床信息,采用Eckardt评分、内镜及食道造影检查评估患者临床疗效。结果20例患者均成功接受POEM手术,无严重并发症发生。术后24个月有效率100%,术后36个月Eckardt评分较术前明显下降(P=0.000),随访至36个月仅有1例Eckardt评分=4分,考虑术后复发,随访至48个月,术后复发病例无新增;最早治疗的1例患者随访至今满6年Eckardt评分仍为1分。结论POEM术治疗贲门失弛缓具有较高的临床疗效及安全性。

Objective To analyze the long-term efficacy and safety of peroral endoscopic myotomy in the treatment of achalasia.Methods Clinical information of 20 patients with achalasia treated with POEM from January 2013 to July 2015 was collected,all patients were followed up for 36 months postoperatively,and clinical efficacy of the patients was evaluated by Eckardt score,endoscopy and contrast esophagography.Results All 20 patients successfully underwent POEM surgery without serious complications.The effective rate was 100%at 24 months after the operation,and the Eckardt score at 36 months after the operation was significantly lower than that before the operation(P<0.001).Only one case’s Eckardt score was 4 points after 36 months of follow-up,considering postoperative recurrence.The first case whose Eckardt score was still 1 point after the followup period of 6 years.Conclusion POEM has a high clinical efficacy and safety in the treatment of achalasia.