贲门失弛缓症的诊治及管理策略

Diagnostic and therapeutic strategies for achalasia of the cardia

贲门失弛缓症(achalasia of cardidia,AC)是一种原发性食管动力障碍性疾病,其诊断的主要依据包括临床症状、食管造影、食管动力学检查及上消化道内镜检查,食管高分辨率测压是金标准.随着新技术的兴起,AC的诊断方式更加丰富,三维建模或许可以促进AC的早期发现,内镜下功能性腔内成像探针可以提高诊断的准确率.常用的治疗方法有内镜下球囊扩张、腹腔镜Heller肌切开术、经口内镜下肌切开术(peroral endoscopic myotomy,POEM)等.POEM已成为目前应用最广泛的治疗方法,大幅提高了AC的临床治疗成功率.本文旨在结合近年来的研究进展,对AC的诊断和治疗进行综述.

The diagnosis of achalasia of the cardidia(AC)is primarily based on clinical symptoms,esophagographic findings,esophagodynamic examination,and upper gastrointestinal endoscopic findings.High resolution manometry is considered the gold standard for diagnosis.With the advan-cement of new technologies,the diagnostic methods for AC have become more diverse,and three-dimensional modeling may facilitate early detection of AC.The use of endoscopic functional intracavity imaging probe can enhance diagnostic accuracy.Common treatment options include endoscopic balloon dilation,laparoscopic Heller myotomy,and peroral endoscopic myotomy(POEM).POEM has emerged as the most widely utilized therapeutic approach currently,significantly improving the clinical success rate in treating AC.This article provides a comprehensive review on recent research progress in the diagnosis and treatment of AC.