高分辨率食管测压在经口内镜下肌切开术治疗贲门失弛缓症中应用的研究进展

Research progress on clinical application of high resolution esophageal manometry in the treatment of achalasia through peroral endoscopic myotomy

贲门失弛缓症(achalasia,AC)是一种原发性食管动力障碍性疾病,目前的治疗方法只能缓解症状,但不能治愈疾病。经口内镜下肌切开术(peroral endoscopic myotomy,POEM)是治疗AC最为有效的治疗方法。对于AC的诊治及POEM术式的选择尚存争议,因此,本文对高分辨率食管测压(high resolution esophageal manometry,HREM)在AC的诊断、POEM手术策略的制定、术后疗效的预测及评估中的临床价值作一概述,以提高临床医生在AC诊治中常规行HREM检测这一重要性理念的认识,提高POEM治疗AC的临床疗效,并对未来优化POEM对AC的诊治进行展望。

Achalasia(AC)is a primary disorder of esophageal motility,for which current treatments are only able to alleviate symptoms,but cannot cure the disease.Peroral endoscopic myotomy(POEM)is the most effective endoscopic technique for the treatment of AC,and has emerged as the preferred treatment modality.The diagnosis and treatment of AC,as well as the selection of POEM surgical approaches,have long been contentious topics.Therefore,this paper summarized the clinical value of high resolution esophageal manometry(HREM)in the diagnosis of AC,the formulation of POEM surgical strategy,and the prediction and evaluation of postoperative efficacy to enhance clinicians'awareness of the importance of routinely performing HREM in the diagnosis and treatment of AC,and to enhance the therapeutic efficacy of POEM when treating AC.On this basis,the future optimization of POEM for the diagnosis and treatment of AC was projected.