经口内镜下肌切开术治疗贲门失弛缓症63例临床分析

Clinical study of 63 cases of achalasia treated by peroral endoscopic myotomy

为评价经口内镜下肌切开术(peroral endoscopic myotomy,POEM)对贲门失弛缓症患者的疗效,纳入2017—2021年于吉林大学中日联谊医院行POEM治疗的63例贲门失弛缓症患者资料进行回顾性分析,收集患者手术情况,术后Eckardt评分、食管高分辨率测压及上消化道造影等数据,与术前对比分析。63例患者平均年龄49.0岁,其中31例女性。术前Eckardt评分为9(3)分,术后为2(2)分,术前和术后Eckardt评分差异有统计学意义(V=1953,P<0.001),术后食管下括约肌压力与术前比较显著降低[9.90(3.35)mmHg比26.80(13.85)mmHg,V=2016,P<0.001]。53例(84.1%)患者POEM术后临床缓解,不良事件发生率为3.2%(2/63),疗效满意。POEM治疗贲门失弛缓症患者安全、有效、微创,近期疗效满意。

In order to evaluate the efficacy of peroral endoscopic myotomy(POEM)for achalasia,data of 63 patients with achalasia who were treated with POEM in China-Japan Union Hospital of Jilin University from 2017 to 2021 were collected.Postoperative Eckardt score,high-resolution manometry and upper gastrointestinal radiography were compared with preoperative data.The mean age of the 63 patients was 49.0 years,and there were 31 famales.The preoperative Eckardt score was 9(3),and the postoperative Eckardt score was 2(2),with significant difference(V=1953,P<0.001).The lower esophageal sphincter pressure decreased significantly after operation compared with that before operation[9.90(3.35)mmHg VS 26.80(13.85)mmHg,V=2016,P<0.001].Fifty-three patients(84.1%)had satisfactory curative effects.The incidence of adverse events was 3.2%(2/63).POEM is safe,effective and minimally invasive for the treatment of achalasia.