JAMA:贲门失弛缓症手术治疗——内镜下肌切开术vs气动扩张

2019-07-11 MedSci MedSci原创

研究认为,内镜下肌切开术仍是贲门失弛缓症的一线治疗手段

内镜下肌切开术(POEM)是治疗弛缓不能的有效手段,近日研究人员比较了气动扩张与POEM对未经治疗的弛缓不能患者的疗效差异。

诊断的贲门失弛缓症且Eckardt评分大于3分的成年未经治疗患者参与研究,64人接受POEM,66人接受30或35mm气囊气动扩张。研究的主要终点为2年随访期间治疗成功,定义为Eckardt 分数≤3以及其他14项次要终点。

患者平均年龄48.6岁,95%的患者完成研究。POEM组92%的患者以及气动扩张组38%的患者治疗成功。次要终点方面组间差异不显著。组间松弛压力以及钡柱高度无显著差异。POEM组反流性食管炎发生率较高。气动扩张后有2例严重不良反应,包括1例穿孔,而POEM后未发生严重不良反应。

研究认为,内镜下肌切开术仍是贲门失弛缓症的一线治疗手段。

原始出处:


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    2019-09-13 lsj637
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    2019-10-21 gostraight
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