摘要
目的探讨经口内镜下肌切开术(POEM)治疗贲门失弛缓症(AC)的临床疗效。方法研究2010年12月～2011年6月确诊为AC并接受POEM治疗的6例患者的临床资料。患者,男3例,女3例,年龄21～46岁,平均37岁,病程4～19年。POEM主要步骤:食管黏膜层切开;分离黏膜下层,建立黏膜下"隧道";胃镜直视下切开环形肌;金属夹关闭黏膜层切口。结果 6例患者均成功接受POEM手术,手术时间60～128min,平均76.5min,黏膜下隧道长度9～12cm,平均10.3cm,环形肌切开长度7～10cm,平均8.2cm,3例出现纵隔和皮下气肿。术后随访l～5个月,平均3.5个月,6例吞咽困难均明显得到解除。结论 POEM治疗AC短期疗效肯定,可以迅速缓解患者吞咽困难,但其长期疗效及远期并发症仍有待随访观察。
[Objective] To evaluate the clinical efficacy of peroral endoscopic myotomy（POEM） for achalasia of cardia（AC）.[Methods] The clinical data of 6 patients diagnosed as having AC and received POEM at our center from December 2010 to June 2010 were reviewed.The patients were 21-46 years old,mean 37 years,whose disease courses lasted for 4-19 years.The key procedures of POEM were as the following esophageal mucosal incision,submucosal tunneling by endoscopic submucosal dissection（ESD）,endoscopic myotomy of the circular muscle and closure of mucosal entry by hemostatic clips.[Results] All the 6 patients underwent POEM successfully.The mean operation time was 76.5 min（ranging 60-128 min）.The mean submucosal tunneling length was 10.3 cm（ranging 9-12 cm）.The mean length of endoscopic myotomy of circular muscle was 8.2 cm（ranging 7-10 cm）.No severe complications related to POEM occurred.Patients were followed up for 1-5 months（mean 3.5 months）.Dysphagia was relieved significantly during the follow-up in all patients.[Conclusion] POEM is very effective to relieve dysphagia in a short period.However,further observation is needed to evaluate long-term efficacy and complications.
出处
《中国内镜杂志》
CSCD
北大核心
2012年第4期376-378,共3页
China Journal of Endoscopy
