摘要
目的:探讨关于贲门失弛缓症(achalasia,AC)的检查及治疗方案的临床意义。方法:搜集西南医科大学附属医院消化内科2014年1月至2017年6月确诊为AC的43例住院患者信息,使用SPSS 17.0进行整理分析。结果:43例AC患者中男女比为1.05.1,差异无统计学意义(P>0.05),发病年龄以50~59岁为发病高峰。有诱因者比例高于无诱因者(2.3.1),诱因中饮食、情绪、精神三者对AC的发病差异无统计学意义(P=0.866)。最常见的症状为反酸和(或)烧心(67.4%),最易合并胃食管反流病(gastroesophageal reflux disease,GERD)。钡餐造影(阳性率81.4%)及胃镜(阳性率48.8%)检查差异有统计学意义(P=0.019),经口内镜下肌切开术(peroral endoscopic myotomy,POEM)较药物及水囊扩张更有效,有效率分别为85.7%,30.0%,37.5%,差异有统计学意义(P=0.033)。结论:在AC的诊断中钡餐造影检查阳性率高于胃镜,药物及水囊扩张为多数人选择的治疗方式,但POEM较前两者更为有效。在AC的诊治过程中,选择更为优化的诊疗方案有利于提高患者预后。
Objective：To investigate the clinical significance of the examination and therapeutic regimens for achalasia of cardia（AC）.Methods：We collected the information of 43 inpatients diagnosed with AC in department of gastroenterology,the affiliated hospital of southwest medical university,from January 2014 to June 2017.The obtained information was analyzed using SPSS 17.0.Results：In the 43 cases of AC,the male-to-female ratio was1.05.1,with no significant difference in the number of cases between male and female patients（P〈0.05）.The age of onset 50-59 years in most cases.There were more patients with predisposing factors than those without predisposing factors（2.3.1）,and the contribution to AC was not significantly different between dietary,emotional,and mental factors（P=0.866）.The most common symptoms were acid reflux and（or）heartburn（67.4%）,and the most frequent complication was gastroesophageal reflux disease.There was a significant difference in the positive rate between barium meal examination and gastroscopy（81.4%vs 48.8%,P=0.019）.Peroral endoscopic myotomy（PO-EM）was more effective than drug treatment and water sac expansion in the treatment of AC（85.7%vs 30.0%/37.5%,P=0.033）.Conclusion：Barium meal examination has a higher positive rate than gastroscopy in the diagnosis of AC.Although drug treatment and water sac expansion are used in most patients,POEM is more effective than the two therapies.In the diagnosis and treatment of AC,optimized regimens help improve the prognosis of patients.
作者
杨琴
吕沐瀚
唐世孝
YANG Qin;LV Muhan;TANG Shixiao(Department of Gastroenterology,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China)
出处
《西南医科大学学报》
2018年第3期259-262,共4页
Journal of Southwest Medical University
关键词
贲门失弛缓症
胃镜检查
钡餐造影
水囊扩张
POEM
Achalasiaofcardia
Gastroscopy
Bariummealexamination
Watersacexpansion
Peroral endoscopic myotomy
