【摘要】 目的比较贲门失弛缓症(AC)患者接受经口内镜下肌切开术(POEM)前后症状变化和食管动力改变,评价POEM治疗AC的有效性。方法对行POEM治疗的25例AC患者术前及术后1个月使用固态高分辨率食管测压系统(HRM)检测吞咽液体食团时下食管括约肌(LES)动力学参数的变化。结果25例患者POEM术治疗前后Eckardt评分有统计学差异(P<0.001);手术前后食管下括约肌长度无明显变化;术前食管下括约肌静息压(LESP)为(27.75±2.44)mmHg,较术后(10.05±1.06)mmHg显著降低,二者差异有统计学意义(P<0.001);液体吞咽4 s后的完整松弛压(IRP)在术前术后分别是(21.81±2.57)mmHg和(7.42±0.98)mm Hg,差异有统计学意义(P<0.001);食管下括约肌松弛率(LESRR)术后较术前明显升高(P<0.05)。结论 POEM能有效改善AC患者的LES松弛障碍,但其远期疗效尚需进一步随访观察。更多还原

【Abstract】 Aim To compare the esophageal motility of patients with achalasia(AC) who underwent peroral endoscopic myotomy(POEM), and to evaluate the efficacy of POEM on AC. Methods Twenty five patients with AC were recruited in this study. The esophageal motility in response to liquid swallow before or 1 month after POEM was detected by high-resolution manometry(HRM) system. Results Eckardt scoring indicated that POEM treatment led to significant improvement of AC related symptom. Lower esophageal sphincter(LESP) as well as 4s integrated relax pressure(IRP) during liquid swallow was significantly decreased after POEM treatment. Lower esophageal sphincter relaxation ratio was increased significantly after POEM. In addition, POEM treatment had no influence on lower esophageal sphincter length. Conclusion POEM treatment may effectively relieve LES relaxation disorder. Further follow-up study is needed to explore its long-term efficacy.更多还原