CAJ | 학술논문

目的研究经口内镜下肌切开术(POEM)治疗贲门失弛缓症(EA)气体相关并发症的发生情况及发生率,并探讨其危险因素.方法回顾性分析我院2011年8月至2013年11月216例接受POEM治疗的EA患者的临床资料,并对气体相关并发症的可能潜在危险因素进行单因素分析和多因素回归分析.结果本组患者气体相关并发症发生率为10.2％ (22/216),单因素分析显示,S形食管、隧道入口采用单纯纵形切口法、隧道宽度≤3 cm、肌切开深度、操作时间为气体相关并发症的危险因素(P＜0.05).多因素分析表明,隧道入口采用单纯纵形切口法、隧道宽度≤3 cm、S形食管为该并发症发生危险因素(P＜0.05).结论隧道入口采用单纯纵形切口法、隧道宽度≤3 cm、S形食管是POEM治疗EA气体相关并发症的独立危险因素,而肌切开深度并非该并发症发生的危险因素.
목적 연구경구내경하기절개술(POEM)치료분문실이완증(EA)기체상관병발증적발생정황급발생솔,병탐토기위험인소.방법 회고성분석아원2011년8월지2013년11월216례접수POEM치료적EA환자적림상자료,병대기체상관병발증적가능잠재위험인소진행단인소분석화다인소회귀분석.결과 본조환자기체상관병발증발생솔위10.2％ (22/216),단인소분석현시,S형식관、수도입구채용단순종형절구법、수도관도≤3 cm、기절개심도、조작시간위기체상관병발증적위험인소(P＜0.05).다인소분석표명,수도입구채용단순종형절구법、수도관도≤3 cm、S형식관위해병발증발생위험인소(P＜0.05).결론 수도입구채용단순종형절구법、수도관도≤3 cm、S형식관시POEM치료EA기체상관병발증적독립위험인소,이기절개심도병비해병발증발생적위험인소.
Objective To investigate the risk factors and incidence of gas-related complications in peroral endoscopic myotomy for easophageal achalasia.Methods Clinical data of 216 patients with achalasia treated by peroral endoscopic myotomy from August 2011 to November 2013 were collected.Potential risk factors for gas-related complications were analyzed by univariate and multivariate analysis.Results The incidence of gas-related complications was 10.2％ (22/216).Univariate analysis showed risk factors for complications were Sigmoid type esophagus,simple longitudinal incision for tunnel entry,tunnel width ≤3 cm,degree of myotomy,and operation time (P ＜ 0.05),while multivariate analysis showed the risk factors were Sigmoid type esophagus,simple longitudinal incision for tunnel entry,and tunnel width ≤3 cm(P ＜ 0.05).Conclusion Simple longitudinal incision for tunnel entry,tunnel width≤3 cm and sigmoid type esophagus are risk factors of gas-related complications in POEM,while myotomy depth is not.