摘要
贲门失弛缓症(achalasia)是一种少见的食管运动障碍性疾病,其病因及发病机制至今仍未明确。临床主要表现为不同程度的吞咽困难、食物反流、误吸、胸痛和体重下降。治疗的主要目的是降低食管下端括约肌压(lower esophageal sphincter pressure,LESP)、缓解症状。治疗方法有多种,包括口服药物治疗、肉毒杆菌毒素注入法、球囊扩张术和手术治疗等。目前,多数学者则更倾向于在腔镜下行手术治疗,从而达到缓解症状、防止反酸等满意的远期疗效。然而,学者之间在非手术与手术的选择、经胸还是经腹、食管肌层切开术远端最佳延伸长度、是否附加抗反流术以及附加何种抗反流术等诸多问题上尚存在较大的争议。为此,我们对贲门失弛缓的治疗现状及进展进行了综述。
Achalasia is a rare motor disorder of the esophagus and its etiology and pathogenesis remain unclear. Its clinical presentation typically includes various degrees of dysphagia, regurgitation, aspiration, chest pain and weight loss. The main therapy purpose for achalasia is to reduce lower esophageal sphincter pressure （LESP） so as to alleviate clinical symptoms. There are a variety of treatment methods for achalasia, such as pharmacotherapy, intrasphincteric botulinum toxin injection, endoscopic pneumatic dilatation and surgical thorascopic surgery to achieve satisfactory long-term results intervention. At present, most scholars prefer laparoscopic or including alleviated symptoms and prevention of acid reflux. However, great controversy still exists among scholars regarding the choice of conservative therapy or surgery, transtho- racic or transabdominal surgery, optimal distal extent of myotomy, the need and choice of additional antireflux procedures. In this review, we focus on current therapy and progress of achalasia.
出处
《中国胸心血管外科临床杂志》
CAS
2014年第1期107-111,共5页
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
