摘要
目的 评估经口内镜下肌切开术与内镜下气囊扩张术治疗贲门失弛缓症的临床应用价值。方法 采用分层随机化将2015年1月至2016年6月本院贲门失弛缓症患者80例分为观察组和对照组,各40例。对照组患者行内镜下气囊扩张术治疗,观察组患者行经口内镜下肌切开术。两组患者治疗前、手术后1个月及术后1年临床症状评分、术后食管高分辨率测压参数、复发率和并发症情况比较。结果两组术后1个月和1年Eckardt评分较手术前均降低,且观察组术后1年的Eckardt评分较对照组降低更明显,差异有统计学意义(P<0.05);两组术后LESP、4S-IRP较术前均降低,LESRR、LESL均增大,且观察组LESP、4S-IRP降低和LESRR、LESL增大均较对照组明显,差异有统计学意义(P<0.05);观察组的术后并发症发生率及术后1年复发率较对照组低,差异有统计学意义(P<0.05)。结论 相比内镜下气囊扩张术,经口内镜下肌切开术治疗贲门失弛缓症临床效果确切,并发症少,复发率低,具有显著的临床应用价值。
Objective To assess the clinical application value of peroral endoscopic myotomy and endoscopic pneumatic dilation in treating achalasia.Methods 80 patients with achalasia from Jan.2015 to Jun.2016 were chosen,and were divided into observation group and control group by the stratified randomization method.The control group was treated by endoscopic pneumatic dilation(PD),while the observation group was treated by peroral endoscopic myotomy(POEM).Eckardt score and high resolution manometry(HRM)were compared between the two groups before surgery,one month and one year after surgery.The recurrence rate and complication rate were compared between the two groups.Results One month and one year after surgery,Eckardt score of the two groups were lower than those before surgery,and Eckardt score of POEM group was lower than that of PD group at one year after surgery,with statistically significant differences(P<0.05).Lower esophageal sphincter pressure(LESP)and 4 second integrate relaxation pressure(4S-IRP)of the two groups after surgery were lower than those before after surgery,and lower esophageal sphincter relaxation rate(LESRR)and lower esophageal sphincter length(LESL)were higher than those before after surgery,and LESP and 4S-IRP of POEM group after surgery were lower than those of PD group,LESRR and LESL of POEM group after surgery were higher than those of PD group,with statistically significant differences(P<0.05).Compared to the control group,the recurrence rate and complication rate were lower in the observation group,with statistically significant differences(P<0.05).Conclusion Compared to PD,POEM is proved to be a very effective treatment for achalasia,with low recurrence rate and few complications,with significant clinical application value.
作者
沈鹏
蒋勇
李福泉
Shen Peng;Jiang Yong;Li Fuquan(Department of Thoracic Surgery,Dongping County People's Hospital,Tai’an 271500,China)
出处
《国际医药卫生导报》
2018年第13期2025-2028,共4页
International Medicine and Health Guidance News
