经口内镜下肌切开术治疗贲门失弛缓症的护理配合体会

目的探讨经口内镜下肌切开术（POEM）治疗贲门失弛缓症（AC）护理配合技巧与安全性。方法研究2011年12月至2012年4月确诊AC并接受POEM治疗护理的8例患者的临床资料。POEM主要手术配合步骤；协助食管黏膜下注射；食管黏膜层切开；分离黏膜下层建立黏膜下“隧道”；内镜直视下纵行切开环形肌；金属钛夹关闭黏膜层切口。结果所有8例患者均成功接受POEM手术，无1例因为护理配合出现与POEM相关的严重并发症。8例患者吞咽困难等症状得到明显改善，均顺利出院。结论经口内镜下肌切开术治疗贲门失弛缓症短期疗效肯定。护理配合中的快、稳、准可有效地减少手术的并发症，提高手术治疗的安全性。

Nursing experience of achalasia of cardia with peroral endoscopic myotomy

Objective To explore nursing matching skills and safety of peroral endoscopic myotomy（POEM） for achalasia of cardia（AC）. Methods The clinical data of 8 patients diagnosed with AC and treated with POEM from December 2011 to April 2012 were reviewed. The main pro- cedures of POEM were as follows： assistant of esophageal submucosal injection, incision of esophageal mucosa layer, construction of submucosal tunnel by submucosa separation, endoscopic longitudinal incision of circular muscle, closure of mucosal entry with Titanium clip. Results All the 8 patients underwent POEM successfully, and no patient was found with severe complications of POEM due to nursing matching. Dysphagia was rdieved significantly in all patients before their suc- cessful discharges. Conclusion POEM is very effective in treating AC in a short period. Fast, steady and accurate nursing matching can effectively reduce the incidence of surgery and improve safety of surgical treatment.