中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2012年
11期
727-730
,共4页
钟芸诗%李亮%周平红%马丽黎%时强%徐美东%任重%朱博群%刘靖正%姚礼庆
鐘蕓詩%李亮%週平紅%馬麗黎%時彊%徐美東%任重%硃博群%劉靖正%姚禮慶
종예시%리량%주평홍%마려려%시강%서미동%임중%주박군%류정정%요례경
贲门失弛缓症%内镜超声检查%手术后并发症
賁門失弛緩癥%內鏡超聲檢查%手術後併髮癥
분문실이완증%내경초성검사%수술후병발증
Esophageal achalasia%Endosonography%Postoperative complications
目的 探讨贲门失弛缓症(EA)患者在行经口内镜肌切开术(POEM)前行超声内镜(EUS)检查的临床价值.方法 2011年8月至11月复旦大学附属中山医院内镜中心共为34例拟行POEM的EA患者(EA组)和30例接受胃EUS检查者(对照组)进行食管EUS检查,分别测取贲门口、贲门上5 cm、贲门上10 cm、贲门上15 cm处固有肌层厚度、环形肌层厚度并计算环形肌层比例.比较组内和组间的肌层厚度差异.观察不同食管肌层厚度与EA患者POEM后并发症的关系.统计学处理采用t检验.结果 EA组和对照组相同部位固有肌层厚度比较差异均无统计学意义(贲门口、贲门上5 cm、贲门上10 cm、贲门上15 cm处的t=1.210、1.116、0、0.292,P均＞0.05).EA组贲门口、贲门上5 cm、贲门上10 cm、贲门上15 cm处环形肌层厚度分别为(1.72±0.49)、(1.86±0.81)、(1.56±0.47)、(1.41±0.48) mm,对照组则分别为(1.06±0.50)、(1.40±0.33)、(1.05±0.37)、(0.78±0.12) mm,相同部位比较,EA组皆厚于对照组(t=5.326、2.903、4.778、6.993,P均＜0.05).相同部位环形肌层比例比较,EA组皆高于对照组.固有肌层厚度＜2 mm的EA患者POEM后并发症发生率较高.结论 EA患者POEM前行EUS检查具有一定的指导意义.
目的 探討賁門失弛緩癥(EA)患者在行經口內鏡肌切開術(POEM)前行超聲內鏡(EUS)檢查的臨床價值.方法 2011年8月至11月複旦大學附屬中山醫院內鏡中心共為34例擬行POEM的EA患者(EA組)和30例接受胃EUS檢查者(對照組)進行食管EUS檢查,分彆測取賁門口、賁門上5 cm、賁門上10 cm、賁門上15 cm處固有肌層厚度、環形肌層厚度併計算環形肌層比例.比較組內和組間的肌層厚度差異.觀察不同食管肌層厚度與EA患者POEM後併髮癥的關繫.統計學處理採用t檢驗.結果 EA組和對照組相同部位固有肌層厚度比較差異均無統計學意義(賁門口、賁門上5 cm、賁門上10 cm、賁門上15 cm處的t=1.210、1.116、0、0.292,P均＞0.05).EA組賁門口、賁門上5 cm、賁門上10 cm、賁門上15 cm處環形肌層厚度分彆為(1.72±0.49)、(1.86±0.81)、(1.56±0.47)、(1.41±0.48) mm,對照組則分彆為(1.06±0.50)、(1.40±0.33)、(1.05±0.37)、(0.78±0.12) mm,相同部位比較,EA組皆厚于對照組(t=5.326、2.903、4.778、6.993,P均＜0.05).相同部位環形肌層比例比較,EA組皆高于對照組.固有肌層厚度＜2 mm的EA患者POEM後併髮癥髮生率較高.結論 EA患者POEM前行EUS檢查具有一定的指導意義.
목적 탐토분문실이완증(EA)환자재행경구내경기절개술(POEM)전행초성내경(EUS)검사적림상개치.방법 2011년8월지11월복단대학부속중산의원내경중심공위34례의행POEM적EA환자(EA조)화30례접수위EUS검사자(대조조)진행식관EUS검사,분별측취분문구、분문상5 cm、분문상10 cm、분문상15 cm처고유기층후도、배형기층후도병계산배형기층비례.비교조내화조간적기층후도차이.관찰불동식관기층후도여EA환자POEM후병발증적관계.통계학처리채용t검험.결과 EA조화대조조상동부위고유기층후도비교차이균무통계학의의(분문구、분문상5 cm、분문상10 cm、분문상15 cm처적t=1.210、1.116、0、0.292,P균＞0.05).EA조분문구、분문상5 cm、분문상10 cm、분문상15 cm처배형기층후도분별위(1.72±0.49)、(1.86±0.81)、(1.56±0.47)、(1.41±0.48) mm,대조조칙분별위(1.06±0.50)、(1.40±0.33)、(1.05±0.37)、(0.78±0.12) mm,상동부위비교,EA조개후우대조조(t=5.326、2.903、4.778、6.993,P균＜0.05).상동부위배형기층비례비교,EA조개고우대조조.고유기층후도＜2 mm적EA환자POEM후병발증발생솔교고.결론 EA환자POEM전행EUS검사구유일정적지도의의.
Objective To explore the clinical value of endoscopic ultrasonography (EUS) examination before esophageal achalasia (EA) patients treated by peroral endoscopic myotomy (POEM).Methods From August 2011 to November 2011,esophageal EUS examination was conducted in 34 EA patients scheduled for POEM treatment (EA group) and 30 cases accepted gastric EUS examination (control group) at endoscopic center,Zhongshan Hospital,Fudan University.The thickness of muscularis propria layer and the circular muscle layer was measured at cardia,5 cm,10 cm and 15 cm above cardia,and the proportion of circular muscle layer was calculated.The differences in groups and between groups were compared.The correlation between muscle thickness and complication after POEM treatment was analyzed.The data were analyzed by t test.Results There was no difference between EA group and control group in the thickness of the muscularis propria layer at same part (at cardia,5 cm,10 cm and 15 cm above cardia,t=1.210,1.116,0 and 0.292respectively; all P＞0.05 respectively).The thickness of the circular muscle layer of EA group at cardia,5 cm,10 cm and 15 cm above cardia was (1.72±0.49) mm,(1.86±0.81) mm,(1.56±0.47) mm and (1.41±0.48) mm respectively,those of control group was (1.06±0.50) mm,(1.40±0.33) mm,(1.05±0.37) mm and (0.78±0.12) mm respectively.At same part,the thickness of the circular muscle layer of EA group was significantly thicker than that of the control group (t =5.326,2.903,4.778 and 6.993 respectively,all P＜0.05).After POEM treatment,complication was high in EA cases with the thickness of muscularis propria layer less than 2 mm.Conclusion Before POEM treatment,EUS examination for EA patients has certain guiding significance.
