摘要
目的评价贲门失弛缓症（AC）使用sB刀进行经口内镜下肌切开术（POEM）治疗的安全性和疗效。方法2013年1月至2014年12月，在武汉大学人民医院消化内科行POEM治疗的58例AC患者纳入前瞻性研究，采用随机数字表法随机分成2组，每组29例，治疗术中分别使用sB刀（sB刀组）和传统Dual刀（Dual刀组），对比分析2组并发症发生情况及治疗效果。结果58例AC患者均顺利完成POEM手术治疗。SB刀组无明显皮下气肿、穿孔和出血等并发症发生，Dual刀组术中出现皮下气肿4例、发生术中出血4例，并发症总发生率SB刀组明显低于Dual刀组[0比27．6％（8／29），P〈0．05]。SB刀组用时（36．32±5．87）min，Dual刀组用时（56．20±14．41）min，组间差异有统计学意义（P〈0．05）。2组治疗后与治疗前比较，症状积分均显著增加（P〈0．05），括约肌静息压均明显降低（P〈0．05），且治疗后症状积分、括约肌静息压2组间比较差异均无统计学意义（P〉0．05）。结论POEM治疗AC过程中使用SB刀安全、有效，较传统Dual刀能有效缩短手术时间、减少并发症的发生。
Objective To investigate the efficacy and safety of SB（ stag beetle） knife in peroral en- doscopic myotomy（POEM） for achalasia（AC）. Methods A total of 58 cases of AC treated with POEM at department of gastroenterology of the People＇s Hospital of Wuhan University from January 2013 to December 2014 were randomly divided into two groups, SB knife group and Dual knife group by using random number table, 29 patients in each group. The complications and therapeutic effects were analyzed. Results All 58 patients with achalasia successfully completed POEM. There were no significant complications in SB knife group such as subcutaneous emphysema, perforation or bleeding.But there were 4 cases of subcutaneous em- physema and 4 cases of bleeding occurred in Dual knife group.The overall incidence of complications was sig- nificantly lower in SB group than that in Dual knife group[ 0 VS 27.6% （8/29） , P〈0. 05 ]. The operation time of SB group was（36. 32±5. 87）mins, which was significant less than that in Dual knife group（56. 20± 14. 41 ） mins （ P〈 0. 05 ）. The symptom scores significantly increased （ P〈 0. 05 ） and the sphincter resting pressure decreased significantly（ P〈0. 05） after POEM treatment compared with before in the two groups, and there was no statistical significance between the two groups （P〉0. 05 ）. Conclusion SB knife is safe and effective for aehalasia with POEM, which can effectively shorten the operation time and reduce the inci- dence of complications.
出处
《中华消化内镜杂志》
北大核心
2016年第7期429-432,共4页
Chinese Journal of Digestive Endoscopy
关键词
食管失弛症
体征和症状
消化系统
SB刀
手术后并发症
Esophageal achalasia
Signs and symptoms, digestive
SB knife
Postoperative complications
