经口内窥镜下肌切开术治疗老年贲门失弛缓症的疗效

中华消化内镜杂志 Pub Date : 2019-04-20 DOI:10.3760/CMA.J.ISSN.1007-5232.2019.04.010

Xin-yang Liu, Jing Cheng, Zuqiang Liu, Quan-Lin Li

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引用次数: 0

摘要

目的评价经口内镜下肌切开术(POEM)治疗老年贲门失弛缓症(AC)的安全性、可行性、围手术期及远期疗效。方法回顾性分析2010年8月至2014年12月中山医院经POEM治疗的41例65岁以上贲门失弛缓症患者的资料。分析围手术期并发症、术前术后食管下括约肌Eckardt评分及压力、食管反流及临床失败情况。结果41例患者均成功行POEM手术，平均手术时间42 min，平均住院时间3 d。发生重大围手术期不良事件4例(9.75%)，住院时间超过5天。中位随访40个月(四分位数间距24-57个月)，中位Eckardt评分从8降至1(P<0.001)，食管下括约肌压力从23.85 mmHg(1 mmHg=0.133 kPa)降至9.05 mmHg(P=0.005)。临床返流12例(29.27%)，POEM 5年成功率87.80%(36/41)。结论POEM是一种安全可靠的治疗老年性AC的方法，短期和长期疗效确切。关键词:食道失弛缓症;老年病学;经口内窥镜肌切开术

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Effects of peroral endoscopic myotomy on achalasia in geriatric patients

Objective To evaluate the safety, feasibility, perioperative and long-term efficacy of peroral endoscopic myotomy (POEM) for achalasia (AC) in geriatric patients. Methods Data of 41 patients aged over 65 diagnosed with achalasia and treated with POEM in Zhongshan Hospital from August 2010 to December 2014 were retrospectively studied. Perioperative complications, preoperative and postoperative Eckardt score and pressure of the lower esophageal sphincter, esophageal reflux and clinical failure were analyzed. Results All 41 patients underwent POEM successfully, with median operation time of 42 min. Median hospitalization was 3 days. Major perioperative adverse events occurred in 4 cases (9.75%), whose hospitalization was longer than 5 days for perioperative adverse events. During median follow-up period of 40 months (interquartile range 24-57 months), median Eckardt score decreased from 8 to 1(P<0.001)and pressure of the lower esophageal sphincter decreased from 23.85 mmHg(1 mmHg=0.133 kPa) to 9.05 mmHg (P=0.005). Clinical reflux occurred in 12 cases (29.27%) and the 5-year success rate of POEM was 87.80% (36/41). Conclusion POEM is a safe and reliable treatment for geriatric AC patients with confirmed short-term and long-term effectiveness. Key words: Esophageal achalasia; Geriatrics; Peroral endoscopic myotomy

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来源期刊

中华消化内镜杂志

CiteScore

0.10

自引率

0.00%

发文量

7555

期刊介绍： Chinese Journal of Digestive Endoscopy is a high-level medical academic journal specializing in digestive endoscopy, which was renamed Chinese Journal of Digestive Endoscopy in August 1996 from Endoscopy. Chinese Journal of Digestive Endoscopy mainly reports the leading scientific research results of esophagoscopy, gastroscopy, duodenoscopy, choledochoscopy, laparoscopy, colorectoscopy, small enteroscopy, sigmoidoscopy, etc. and the progress of their equipments and technologies at home and abroad, as well as the clinical diagnosis and treatment experience. The main columns are: treatises, abstracts of treatises, clinical reports, technical exchanges, special case reports and endoscopic complications. The target readers are digestive system diseases and digestive endoscopy workers who are engaged in medical treatment, teaching and scientific research. Chinese Journal of Digestive Endoscopy has been indexed by ISTIC, PKU, CSAD, WPRIM.