经口内镜下环形肌切开术对老年贲门失弛缓症LES功能及有效率的影响研究

Effect of POEM on function of lower esophageal sphincter and effective rate of patients with achalasia of cardia in elderly

目的研究将经口内镜下环形肌切开术(peroral endoscopic myotomy,POEM)应用于老年贲门失弛缓症患者中的作用与效果。方法选取102例2019年12月—2021年6月南阳市第二人民医院收治的老年贲门失弛缓症患者,根据不同治疗方式划分组别,行球囊扩张手术的51例作为对照组,应用POEM的51例作为观察组,比较两组应用的效果。结果(1)观察组的住院时间、手术时间显著高于对照组,组间差异显著(P<0.05)。(2)观察组的总有效率(98.04%)显著高于对照组(78.43%),组间差异有统计学意义(P<0.05)。(3)观察组的食管下括约肌压(LESP)、4 s整合松弛压(4s-IRP)显著低于对照组,而其食管下括约肌松弛率(LESRR)显著高于对照组,组间差异有统计学意义(P<0.05)。结论老年贲门失弛缓症治疗工作中应用POEM能够改善患者4s-IRP、LESP、LESRR,并提升其总有效率,能够给临床中贲门类疾病方面的治疗给予更多的参照,可应用与推广。

Objective To study the effect and effect of peroral endoscopic myotomy(POEM)in elderly patients with achalasia of cardia.Methods Totally 102 cases of elderly patients with achalasia of cardia received and treated in our hospital from December 2019 to June 2021 were selected and divided into groups according to different treatment methods.Fifty-one cases of patients receiving balloon dilation surgery were taken as the control group,and 51 cases of POEM were taken as the observation group.The effects of the two groups were compared.Results(1)The hospital stay and operation time of the observation group were significantly higher than those of the control group(P<0.05).(3)The total effective rate of the observation group was significantly higher than that of the control group,P<0.05.(3)The lower esophageal sphincter pressure(LESP)and 4 s integrated relaxation pressure(4 s-IRP)of the observation group were significantly lower than those of the control group,while the lower esophageal sphincter relaxation rate(LESRR)of the observation group was significantly higher than that of the control group,P<0.05.Conclusion The application of POEM in the treatment of elderly achalasia of cardia can improve 4 s-IRP,LESP and LESRR,and enhance the total effective rate.POEM can provide more references for the treatment of clinical achalasia of cardia,and can be applied and promoted.