贲门失弛缓症经口内镜下肌切开术后复发危险因素分析

doi:10.3969/j.issn.1006-7795.2023.06.012

首都医科大学学报 ›› 2023, Vol. 44 ›› Issue (6): 978-981.doi: 10.3969/j.issn.1006-7795.2023.06.012

• 消化系统疾病诊疗技术与进展 • 上一篇下一篇

贲门失弛缓症经口内镜下肌切开术后复发危险因素分析

刘娟，王文静，赵桂平，王拥军，李鹏，吴咏冬，张澍田^*

首都医科大学附属北京友谊医院消化内科国家消化系统疾病临床医学研究中心，北京 100050

收稿日期:2023-08-15 出版日期:2023-12-21 发布日期:2023-12-20
通讯作者: 张澍田 E-mail:zhangshutian@ccmu.edu.cn
基金资助:
国家自然科学基金项目(82203266)。

Risk factors associated with recurrence of achalasia after peroral endoscopic myotomy

Liu Juan, Wang Wenjing, Zhao Guiping, Wang Yongjun, Li Peng, Wu Yongdong, Zhang Shutian^*

Department of Gastroenterology, Beijing Friendship Hospital, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing 100050, China

Received:2023-08-15 Online:2023-12-21 Published:2023-12-20
Supported by:
This study was supported by National Natural Science Foundation of China (82203266).

摘要/Abstract

摘要： 目的探索经口内镜下肌切开术(peroral endoscopic myotomy，POEM)治疗贲门失弛缓症（achalasia,AC)术后复发的危险因素。方法回顾性分析2014年至2019年因AC就诊于首都医科大学附属北京友谊医院并成功行POEM治疗的81例患者的临床资料，应用多因素COX回归分析POEM术后AC复发的危险因素。结果 6例（7.41%)患者POEM术后出现AC复发，中位复发时间为3年。与未复发组相比，性别（P =0.04)及吸烟史（P =0.02)差异有统计学意义。而发病年龄、病程、饮酒史、综合松弛压（integrated relaxation pressure，IRP)、术前食管宽度及食管贲门固有肌层厚度在两组中差异均无统计学意义。进一步多因素COX回归分析显示，吸烟史是POEM术后AC复发的独立危险因素（HR =10.84，P=0.04)。结论吸烟史是POEM术后AC复发的独立危险因素。

关键词: 贲门失弛缓症, 经口内镜下肌切开术, 危险因素

Abstract: Objective To analyze the risk factors associated with recurrence of achalasia (AC) treated with peroral endoscopic myotomy (POEM). Methods The data of 81 patients diagnosed with AC and underwent POEM at Beijing Friendship Hospital from 2014 to 2019 were collected retrospectively, and multivariate Logistic regression analysis was conducted to analyze the risk factors of recurrence after POEM. Results Postoperative recurrence occurred in 6 patients, recurrence rate was 7.41% and the medium recurrence duration was 3 years. Gender （P =0.04)and smoking （P=0.02) were related to the recurrence of AC after POEM. There was no significant difference between the groups in age, disease duration, drinking, integrated relaxation pressure (IRP), esophageal diameter and muscularis propria layer thickness. Further COX regression analysis showed that the smoking was an independent risk factor for recurrence of AC after POEM （HR=10.84，P =0.04). Conclusion Smoking was an independent risk factor for recurrence of AC after POEM.

Key words: achalasia, peroral endoscopic myotomy, risk factors

中图分类号:

R573

刘娟, 王文静, 赵桂平, 王拥军, 李鹏, 吴咏冬, 张澍田. 贲门失弛缓症经口内镜下肌切开术后复发危险因素分析[J]. 首都医科大学学报, 2023, 44(6): 978-981.

Liu Juan, Wang Wenjing, Zhao Guiping, Wang Yongjun, Li Peng, Wu Yongdong, Zhang Shutian. Risk factors associated with recurrence of achalasia after peroral endoscopic myotomy[J]. Journal of Capital Medical University, 2023, 44(6): 978-981.

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贲门失弛缓症经口内镜下肌切开术后复发危险因素分析

Risk factors associated with recurrence of achalasia after peroral endoscopic myotomy

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