经口内镜下环行肌切开术治疗贲门失弛缓症34例的初步分析

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1、山东大学硕士学位论文years(12～80)；meandiseasedurationwas5．5years(0．5～20)；theaverageoperationtimewas114．5mins(60-210)；meansubmucosal”tunnel”lengthwas10．2cm(7-13)；averagecircularmuscleincisionlengthwas6．9cm(4～11)．Noonehadseriouscomplications．Amongthem，intheopermionprocessof9casesusingairpumppati

2、ents，7cases(77．8％)appearedintheneck，chestsubcutaneousemphysema，and25casesofusingC02pump，only3patients(12％)hadsubcutaneousemphysema．Theremainingshort-termcomplicationsincludedfeverin5cases(14．7％)，abdominaldistentionin4cases(11．8％)，and2casesofretrostemaldiscomfort(5．9％)．Thesymptomswer

3、eallinremissionin1to3daysafteroperation．PreoperativeEckardtscore(8．3士2)VSpostoperation(1．1土1．3)，andthedifferencewasstatisticallysignificantrP

4、operativeesophagealmanometryonemonthlatershowed1．1-15．8mmHg，andtheaveragewas(8．6士6．1)mmHg，whichislowerthanthepreoperativeesophagealmanometry．Thedifferencewasstatisticallysignificant(P<0．005)．ConelusionsAsanew,minimally．invasivetreatmentforachalasia,POEMmaybecomethefirstlinetherapyin

5、future．Short-termresultsarepromisingwithreliefofsymptomsanddecreaseoftheLESpressure．Butlong-termcomplicationssuchasgastroesophagealrefluxshouldbeobserved．[Keywords]myotomy,achalasia，Endoscope，Therapy4山东大学硕士学位论文英文缩写英文名称POEMACLESLESPESDEMRNOTESGEJPPILHMBMINP0GERD符号说明peroralendoscopicm

6、yotomyachalasialoweresophagealsphincterloweresophagealsphincterpressureendoscopicsubmucosaldissectionendoscopicmucosalresectionnaturalorificetransluminalendoscopicsurgerygastro-esophagealjunctionproton—pumpinhibitorlaparoscopicHellermyotomybodymassindexnilperOSgastroesophagealreflux

7、disease中文名称经口内镜下环形肌切开术责门失弛缓症食管下括约肌食管下括约肌压力内镜黏膜下剥离术内镜下黏膜切除术经自然腔道内镜手术胃食管交界处质子泵抑制剂腹腔镜Heller肌切开术体重指数禁饮食胃食管反流病5山东大学硕士学位论文经口内镜下环行肌切开术治疗贲门失弛缓症34例的初步研究硕士研究生：王亚甜专业：内科学(消化系病)导师：卢雪峰教授刖置贲门失弛缓症(AC)是一种以食管下括约肌(LES)松弛功能受损，食管蠕动波减少或消失为特征的原发性食管动力障碍性疾病。本病无明显解剖学异常，但存在明显的组织学改变，即支配LES和远端食管壁的肌间神经丛抑制性神经元发生不

8、可逆性丧失，但原因迄今未明确。吞咽困难