摘要
目的探讨贲门失弛缓症（EA）患者在行经口内镜肌切开术（POEM）前行超声内镜（EUS）检查的临床价值。方法2011年8月至11月复旦大学附属中山医院内镜中心共为34例拟行POEM的EA患者（EA组）和30例接受胃EUS检查者（对照组）进行食管EUS检查，分别测取贲门口、贲门上5cm、贲门上10cm、贲门上15cm处固有肌层厚度、环形肌层厚度并计算环形肌层比例。比较组内和组间的肌层厚度差异。观察不同食管肌层厚度与EA患者POEM后并发症的关系。统计学处理采用t检验。结果EA组和对照组相同部位固有肌层厚度比较差异均无统计学意义（贲门口、贲门上5cm、贲门上10cm、贲门上15cm处的t=1．210、1．116、0、0．292，P均〉0．05）。EA组责门口、贲门上5cm、贲门上10cm、贲门上15cm处环形肌层厚度分别为（1．72±0．49）、（1．86±0．81）、（1．56±0．47）、（1．41±0．48）mm，对照组则分别为（1．06±0．50）、（1．40±0．33）、（1．05±0．37）、（0．78±0．12）mm，相同部位比较，EA组皆厚于对照组（t=5．326、2．903、4．778、6．993，P均〈0．05）。相同部位环形肌层比例比较，EA组皆高于对照组。固有肌层厚度〈2mm的EA患者POEM后并发症发生率较高。结论EA患者POEM前行EUS检查具有一定的指导意义。
Objective To explore the clinical value of endoscopic ultrasonography （EUS） examination before esophageal achalasia （EA） patients treated by peroral endoscopic myotomy （POEM）. Methods From August 2011 to November 2011, esophageal EUS examination was conducted in 34 EA patients scheduled for POEM treatment （EA group） and 30 cases accepted gastric EUS examination （control group） at endoscopic center, Zhongshan Hospital, Fudan University. The thickness of muscularis propria layer and the circUlar muscle layer was measured at cardia, 5 cm, 10 cm and 15 cm above cardia, and the proportion of circular muscle layer was calculated. The differences in groups and between groups were compared. The correlation between muscle thickness and complication after POEM treatment was analyzed. The data were analyzed by t test. Results There was no difference between EA group and control group in the thickness of the muscularis proprialayer at same part （at cardia, 5 cm, 10 cm and 15 cm above cardia, t=1 210, 1. 116, 0 and 0. 292 respectively; all P〉0.05 respectively）. The thickness of the circular muscle layer of EA group at cardia, 5 cm, 10 cm and 15 cm above cardia was （1.72±0.49） mm, （1.86±0.81） mm, （1.56± 0.47） mm and （1.41±0.48） mm respectively, those of control group was （1. 06±0.50） mm, （1.40± 0.33） mm, （1.05±0.37） mm and （0.78±0.12） mm respectively. At same part, the thickness of the circular muscle layer of EA group was significantly thicker than that of the control group （t =5. 326, 2. 903, 4. 778 and 6. 993 respectively, all P〈0.05）. After POEM treatment, complication was high in EA cases with the thickness of muscularis propria layer less than 2 mm. Conclusion Before POEM treatment, EUS examination for EA patients has certain guiding significance.
出处
《中华消化杂志》
CAS
CSCD
北大核心
2012年第11期727-730,共4页
Chinese Journal of Digestion
基金
国家自然科学青年基金（81101566）
上海市科学技术委员会项目（09DZ1950102、10411962300、09411967100）
上海市卫生局新优青计划（XYQ2011017）
