摘要
目的对比改良经口内镜下肌切开术(POEM)与传统POEM治疗贲门失弛缓症(AC)的效果及安全性。方法选取2020年1月至2022年12月我院收治的87例AC患者,按术式不同分为传统POEM组(n=45,实施传统POEM)和改良POEM组(n=42,实施改良POEM)。比较两组的手术指标、AC临床症状评分系统(Eckardt)评分、手术成功率、食管下段括约肌(LES)压力、术后并发症发生率及复发率。结果改良POEM组手术时间短于传统POEM组(P<0.05);两组的住院时间比较无统计学差异(P>0.05)。组内于Eckardt评分上的主效应有差异(P<0.05),组间于Eckardt评分上的主效应未见差异(P>0.05),不存在交互作用(P>0.05),两组均手术成功。术后6个月,两组LES压力均低于术前(P<0.05),而组间比较未见差异(P>0.05)。改良POEM组术后并发症发生率为4.76%,低于传统POEM组的22.22%(P<0.05);两组的复发率(2.38%vs.6.67%)比较无统计学差异(P>0.05)。结论改良POEM和传统POEM治疗AC的效果均较佳,均可明显降低LES压力,有效改善症状,但和传统POEM相比,改良POEM的手术时间更短,并发症发生率更低。
Objective To compare the effect and safety of modified peroral endoscopic myotomy(POEM)and traditional POEM in the treatment of achalasia(AC).Methods 87 AC patients admitted to our hospital from January 2020 to December 2022 were divided into traditional POEM group(n=45,traditional POEM)and modified POEM group(n=42,modified POEM)according to the different surgical methods.The surgical indicators,AC Clinical Symptom Scoring System(Eckardt)score,surgical success rate,lower esophageal sphincter(LES)pressure,postoperative complications,and recurrence rate were compared between the two groups.Results The surgical time of the modified POEM group was shorter than that of the traditional POEM group(P<0.05);No statistical difference was found in the hospitalization time between the two groups(P>0.05).Difference was found in the main effect on the Eckardt score within the group(P<0.05),while no difference was found in the main effect on the Eckardt score between the groups(P>0.05),and there was no interaction(P>0.05).Both groups had successful surgery.6 months after surgery,the LES pressure of both groups were lower than before surgery(P<0.05),but without difference between the groups(P>0.05).The incidence of complications in the modified POEM group was 4.76%,lower than 22.22%in the traditional POEM group(P<0.05);No statistical difference was found in the recurrence rate(2.38%vs.6.67%)between the two groups(P>0.05).Conclusions Both modified POEM and traditional POEM have better effects in the treatment of AC,can significantly reduce the LES pressure,and effectively improve the symptoms.However,compare with traditional POEM,modified POEM has shorter surgical time and lower incidence of complications.
作者
江南
许亚聪
刘佳瑶
孙荣
郑高歌
徐菱遥
闫春晓
JIANG Nan;XU Yacong;LIU Jiayao;SUN Rong;ZHENG Gaoge;XU Lingyao;YAN Chunxiao(Department of Gastroenterology,the First Affiliated Hospital of Henan University,Kaifeng 475001,China)
出处
《临床医学工程》
2025年第2期133-136,共4页
Clinical Medicine & Engineering
基金
河南省医学科技攻关计划联合共建项目(项目编号:LHGJ20200545)。
