CAJ | 학술논문

目的探讨经口内镜下环形肌切开术(POEM)治疗儿童贲门失弛缓症(AC)的可行性、安全性及疗效.方法对2012年1月至2014年12月西安市儿童医院及上海复旦医科大学中山医院消化内镜中心的21例儿童AC患者进行POEM治疗,观察手术相关并发症和食管反流发生情况,并对比分析治疗前后Eckardt评分和食管下段括约肌压力变化.结果 21例均成功实施POEM手术,无一例出现与POEM相关的严重并发症.术后随访时间20.4个月(9～36个月),所有患者症状缓解[Eckardt评分平均分从术前的8.1分降至术后的0.8分(P＜0.01)],食管括约肌压力明显降低[平均压从术前的30.2 mmHg(1 mmHg =0.133 kPa)下降至术后的11.5 mmHg(P ＜0.01)],食管反流总发生率为19.0％ (4/21).结论 POEM用于儿童AC的治疗是安全的,并且具有较好的远期疗效.
목적 탐토경구내경하배형기절개술(POEM)치료인동분문실이완증(AC)적가행성、안전성급료효.방법 대2012년1월지2014년12월서안시인동의원급상해복단의과대학중산의원소화내경중심적21례인동AC환자진행POEM치료,관찰수술상관병발증화식관반류발생정황,병대비분석치료전후Eckardt평분화식관하단괄약기압력변화.결과 21례균성공실시POEM수술,무일례출현여POEM상관적엄중병발증.술후수방시간20.4개월(9～36개월),소유환자증상완해[Eckardt평분평균분종술전적8.1분강지술후적0.8분(P＜0.01)],식관괄약기압력명현강저[평균압종술전적30.2 mmHg(1 mmHg =0.133 kPa)하강지술후적11.5 mmHg(P ＜0.01)],식관반류총발생솔위19.0％ (4/21).결론 POEM용우인동AC적치료시안전적,병차구유교호적원기료효.
Objective To explore the feasibility, safety and the efficacy of peroral endoscopic myotomy (POEM) for pediatric patients with achalasia.Methods A total of 21 patients (mean age 2 years, range 11 months-7 years) with AC were enrolled and underwent POEM from January 2012 to December 2014.Procedure-related complications, reflux esophagitis were observed.Eckardt score and the pressure of the lower esophageal sphincter (LES) were analysed.Results All patients underwent POEM successfully.No serious POEM-related complications were observed.During a mean follow-up period of 20.4 months (range 9-36 months), mean Eckardt score decreased from 8.1 to 0.8 after treatment (P ＜ 0.01).Mean LES treatment also decreased from 30.2 mmHg to 11.5 mmHg after the operation (1 mmHg =0.133 kPa, P ＜ 0.01).Reflux esophagitis developed in four patients (19.0％ ,4/21).Conclusion POEM is safe and effective treatment for pediatric patients with achalasia.