中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2015年
2期
162-164
,共3页
腹腔镜%贲门%肌张力弛缓
腹腔鏡%賁門%肌張力弛緩
복강경%분문%기장력이완
Laparoscopes%Cardia%Hypotpnia
目的 探讨应用腹腔镜改良Heller术联合Dor术治疗老年贲门失弛缓症患者的临床意义. 方法 分析自2009年10月至2013年12月经腹行改良Heller术联合Dor术治疗贲门失弛缓症9例老年患者的临床资料,评价其临床疗效及不良反应. 结果 9例贲门失弛缓症患者手术均获成功,无中转开腹手术和并发症出现.复查显示食管最大直径由(3.69±1.34)cm减少至(1.94±0.76) cm(P＜0.05),食管下括约肌静息压平均下降12.18 mmHg(1 mmHg=0.133 kPa,P＜0.05),吞咽困难评分由术前平均7.88分降至2.49分(P＜0.05).未见胸骨后疼痛和吞咽困难,食管下段、贲门处未发现狭窄和食物潴留,食管无明显扩张. 结论 经腹行改良Heller术联合Dor术能改善老年贲门失弛缓症患者的症状,有效防止术后胃食管反流,且具有微创、快速、并发症少等特点.
目的 探討應用腹腔鏡改良Heller術聯閤Dor術治療老年賁門失弛緩癥患者的臨床意義. 方法 分析自2009年10月至2013年12月經腹行改良Heller術聯閤Dor術治療賁門失弛緩癥9例老年患者的臨床資料,評價其臨床療效及不良反應. 結果 9例賁門失弛緩癥患者手術均穫成功,無中轉開腹手術和併髮癥齣現.複查顯示食管最大直徑由(3.69±1.34)cm減少至(1.94±0.76) cm(P＜0.05),食管下括約肌靜息壓平均下降12.18 mmHg(1 mmHg=0.133 kPa,P＜0.05),吞嚥睏難評分由術前平均7.88分降至2.49分(P＜0.05).未見胸骨後疼痛和吞嚥睏難,食管下段、賁門處未髮現狹窄和食物潴留,食管無明顯擴張. 結論 經腹行改良Heller術聯閤Dor術能改善老年賁門失弛緩癥患者的癥狀,有效防止術後胃食管反流,且具有微創、快速、併髮癥少等特點.
목적 탐토응용복강경개량Heller술연합Dor술치료노년분문실이완증환자적림상의의. 방법 분석자2009년10월지2013년12월경복행개량Heller술연합Dor술치료분문실이완증9례노년환자적림상자료,평개기림상료효급불량반응. 결과 9례분문실이완증환자수술균획성공,무중전개복수술화병발증출현.복사현시식관최대직경유(3.69±1.34)cm감소지(1.94±0.76) cm(P＜0.05),식관하괄약기정식압평균하강12.18 mmHg(1 mmHg=0.133 kPa,P＜0.05),탄인곤난평분유술전평균7.88분강지2.49분(P＜0.05).미견흉골후동통화탄인곤난,식관하단、분문처미발현협착화식물저류,식관무명현확장. 결론 경복행개량Heller술연합Dor술능개선노년분문실이완증환자적증상,유효방지술후위식관반류,차구유미창、쾌속、병발증소등특점.
Objective To explore the clinical significance of application of trans-abdominal Heller combined with Dor fundoplication for esophageal achalasia in the elderly.Methods Clinical data of 9 patients with esophageal achalasia undergoing trans-abdominal Heller combined with Dor fundoplication from Oct.2009 to Dec.2013 were collected.The postoperative effects and complications were analyzed.Results The operations were successful in the 9 patients with no conversion to open operation and no complications.The maximum esophageal diameter was reduced to (1.94 ± 0.76) cm from (3.69 ±-1.34) cm (P＜ 0.05).Rest lower esophageal sphincter pressure declined by 12.18 mmHg in average (1 mmHg=0.133 kPa,P＜0.05).Dysphagia score fell to 2.49 points from 7.88 points (P＜0.05).There were no retrosternal pain and dysphagia,stenosis and food retention in the lower esophagus and cardia place,and obvious expansion in esophageal.There were statistically significant differences in the above indexes.Conclusions The trans-abdominal Heller combined with Dor fundoplication can significantly improve the symptoms of esophageal achalasia in elderly patients,and effectively prevent postoperative gastroesophageal reflux,and has the characteristics being minimally invasive and fast,and fewer complications.
