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...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.展开更多
Achalasia can significantly impair the quality of life.The clinical presentation typically includes dysphagia to both solids and liquids,chest pain,and regurgitation.Diagnosis can be delayed in patients with atypical ...Achalasia can significantly impair the quality of life.The clinical presentation typically includes dysphagia to both solids and liquids,chest pain,and regurgitation.Diagnosis can be delayed in patients with atypical presentations,and they might receive a wrong diagnosis,such as gastroesophageal reflux disease(GERD),owing to overlapping symptoms of both disorders.Although the cause of achalasia is poorly understood,its impact on the motility of the esophagus and gastroesophageal junction is well established.Several treatment modalities have been utilized,with the most common being surgical Heller myotomy with concomitant fundoplication and pneumatic balloon dilatation.Recently,peroral endoscopic myotomy(POEM)has gained popularity as an effective treatment for achalasia,despite a relatively high incidence of GERD occurring after treatment compared to other modalities.The magnitude of post-POEM GERD depends on its definition and is influenced by patient and procedure-related factors.The longterm sequelae of post-POEM GERD are yet to be determined,but it appears to have a benign course and is usually manageable with clinically available modalities.Identifying risk factors for post-POEM GERD and modifying the POEM procedure in selected patients may improve the overall success of this technique.展开更多
文摘贲门失弛缓症(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.
文摘Achalasia can significantly impair the quality of life.The clinical presentation typically includes dysphagia to both solids and liquids,chest pain,and regurgitation.Diagnosis can be delayed in patients with atypical presentations,and they might receive a wrong diagnosis,such as gastroesophageal reflux disease(GERD),owing to overlapping symptoms of both disorders.Although the cause of achalasia is poorly understood,its impact on the motility of the esophagus and gastroesophageal junction is well established.Several treatment modalities have been utilized,with the most common being surgical Heller myotomy with concomitant fundoplication and pneumatic balloon dilatation.Recently,peroral endoscopic myotomy(POEM)has gained popularity as an effective treatment for achalasia,despite a relatively high incidence of GERD occurring after treatment compared to other modalities.The magnitude of post-POEM GERD depends on its definition and is influenced by patient and procedure-related factors.The longterm sequelae of post-POEM GERD are yet to be determined,but it appears to have a benign course and is usually manageable with clinically available modalities.Identifying risk factors for post-POEM GERD and modifying the POEM procedure in selected patients may improve the overall success of this technique.
