经口内镜下肌切开术在儿童贲门失弛缓症中的应用

目的探讨经口内镜下肌切开术(POEM)治疗儿童贲门失弛缓症(AC)的临床疗效及并发症发生情况。方法回顾性分析该院2012年11月-2016年11月确诊AC并接受POEM治疗的17例患儿的临床表现、POEM手术过程及术后随访情况。结果 17例患儿均成功完成POEM,无严重并发症发生,手术时间(62.65±35.54)min;17例患儿术后随访12~36个月,手术前后AC临床症状评分(Eckardt评分)分别为5(4.0-6.0)和0(0.0-1.0)分,差异有统计学意义(P=0.000),临床症状明显缓解,体重减轻情况明显改善。结论 POEM治疗儿童AC安全性高,短期疗效确切,长期疗效及远期并发症有待大样本量的随访监测。

Application of peroral endoscopic myotomy in treatment of childhood achalasia cardia

Abstract: Objective To observe the clinical efficacy and complications of peroral endoscopic myotomy (POEM) in treatment of childhood achalasia cardia (AC). Methods 17 children with achalasia cardia underwent POEM procedures from November 2012 to November 2016 were enrolled. All the data of clinical manifestations, POEM procedures, outcomes and follow-up situations were analyzed statistically. Results All the POEM procedures in 17 cases were completed successfully without serious complications. The average operative time was (62.65 ± 35.54) min. All the patients were followed up for 12 ~ 36 months. The average Eckardt score decreased significantly after the procedure 5 (4.0 - 6.0) vs 0 (0.0 - 1.0), P = 0.000]. The clinical symptoms were significantly reduced including a marked improvement of body weight. Conclusion POEM is safe and effective for the therapy of achalasia cardia in childhood. The long-term effect and complications should be monitored by large sample size.