高分辨率食管測壓在賁門失弛緩癥經(jīng)口內(nèi)鏡下肌切開術(shù)效果評價(jià)中的價(jià)值
發(fā)布時(shí)間：2019-06-21 06:36
【摘要】：目的觀察經(jīng)口內(nèi)鏡下肌切開術(shù)(POEM)治療賁門失弛緩癥(AC)前后食管壓力的變化,并探討食管高分辨率測壓(HRM)在評價(jià)POEM療效中的價(jià)值。方法收集2015年8月-2016年11月在鄭州大學(xué)第一附屬醫(yī)院確診為AC并接受POEM治療者38例,分別在術(shù)前、術(shù)后1周和術(shù)后1個(gè)月,采用食管HRM檢測食管上擴(kuò)約肌靜息壓(UESP)、食管下括約肌靜息壓(LESP)和食管下括約肌4秒完整松弛壓(4s IRP),評價(jià)療效進(jìn)行回顧性分析。結(jié)果38例AC患者的POEM均順利完成�；颊咝g(shù)后1周、術(shù)后1個(gè)月的食管UESP分別為(45.34±26.52)和(41.27±20.09)mm Hg,與術(shù)前(49.58±26.47)mm Hg相比差異無統(tǒng)計(jì)學(xué)意義(t_(術(shù)后1周/術(shù)前)=0.49,t_(術(shù)后1個(gè)月/術(shù)前)=1.09,均P0.05);術(shù)后1周和術(shù)后1個(gè)月的食管LESP、4s IRP與術(shù)前相比差異均具有統(tǒng)計(jì)學(xué)意義(LESP:t_(術(shù)后1周/術(shù)前)=3.86,t_(術(shù)后1個(gè)月/術(shù)前)=4.86;4s IRP:t_(術(shù)后1周/術(shù)前)=4.85,t_(術(shù)后1個(gè)月/術(shù)前)=7.14;均P0.05);術(shù)后1周與術(shù)后1個(gè)月相比,UESP、LESP、4s IRP變化差異均無統(tǒng)計(jì)學(xué)意義(UESP:t_(術(shù)后1周/術(shù)后1個(gè)月)=0.53,LESP:t_(術(shù)后1周/術(shù)后1個(gè)月)=1.86;4s IRP:t_(術(shù)后1周/術(shù)后1個(gè)月)=1.84,均P0.05)。結(jié)論P(yáng)OEM后食管LESP明顯降低,吞咽困難改善,食管HRM對于評價(jià)AC經(jīng)POEM術(shù)的療效有臨床意義。
[Abstract]:Objective to observe the changes of esophageal pressure before and after endoscopic myotomy (POEM) in the treatment of achalasia of cardia (AC), and to explore the value of high resolution esophageal manometry (HRM) in evaluating the efficacy of POEM. Methods 38 patients with AC diagnosed and treated with POEM in the first affiliated Hospital of Zhengzhou University from August 2015 to November 2016 were collected. Esophageal HRM was used to detect the resting pressure of (UESP), lower esophageal sphincter and 4 seconds complete relaxation pressure of lower esophageal sphincter before, 1 week and 1 month after operation, respectively. The efficacy of (LESP) and 4 seconds complete relaxation pressure of inferior esophageal sphincter was analyzed retrospectively. Results POEM was successfully completed in 38 patients with AC. The esophageal UESP of the patients 1 week after operation and 1 month after operation were (45.34 鹵26.52) and (41.27 鹵20.09) mm Hg,), respectively, which were not significantly different from those before operation (49.58 鹵26.47) mm Hg) (t _ (1 week / before operation) = 0.49, t _ (1 month / before operation) = 1.09, P 0.05). The esophageal LESP,4s IRP at 1 week and 1 month after operation was significantly different from that before operation (LESP:t_ (1 week / pre-operation) = 3.86, t _ (1 month / pre-operation) = 4.86 鈮，
本文編號：2503870
[Abstract]:Objective to observe the changes of esophageal pressure before and after endoscopic myotomy (POEM) in the treatment of achalasia of cardia (AC), and to explore the value of high resolution esophageal manometry (HRM) in evaluating the efficacy of POEM. Methods 38 patients with AC diagnosed and treated with POEM in the first affiliated Hospital of Zhengzhou University from August 2015 to November 2016 were collected. Esophageal HRM was used to detect the resting pressure of (UESP), lower esophageal sphincter and 4 seconds complete relaxation pressure of lower esophageal sphincter before, 1 week and 1 month after operation, respectively. The efficacy of (LESP) and 4 seconds complete relaxation pressure of inferior esophageal sphincter was analyzed retrospectively. Results POEM was successfully completed in 38 patients with AC. The esophageal UESP of the patients 1 week after operation and 1 month after operation were (45.34 鹵26.52) and (41.27 鹵20.09) mm Hg,), respectively, which were not significantly different from those before operation (49.58 鹵26.47) mm Hg) (t _ (1 week / before operation) = 0.49, t _ (1 month / before operation) = 1.09, P 0.05). The esophageal LESP,4s IRP at 1 week and 1 month after operation was significantly different from that before operation (LESP:t_ (1 week / pre-operation) = 3.86, t _ (1 month / pre-operation) = 4.86 鈮，
本文編號：2503870
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