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定义"真正的酸性反流"后口腔内镜肌肉切除术的阿喀拉西亚:一个前性队列研究
Aniruddha Pratap Singh1, Neeraj Singla1, Ekant Budhwani1
1Department of Medical Gastroenterology, AIG Hospitals, Hyderabad, India.
Gastrointestinal endoscopy
|August 20, 2023
概括
在口腔内镜肌切除术 (POEM) 后的阿喀拉西亚患者中,真酸逆流发生在29.6%的病例中. 随着年龄的增长和手术前综合放松压力 (IRP) 是这种情况的关键风险因素.
科学领域:
- 胃肠病学 胃肠病学
- 内視鏡外科手術 內視鏡外科手術
- 食道生理学 食道生理学
背景情况:
- 术后内镜肌切除术 (POEM) 的症状,通常归因于胃食道逆流.
- 目前的治疗重点是抑制酸性,但非反流性酸化也可能有所贡献.
- 识别真正的酸性反流对于POEM后阿喀拉西亚患者的向治疗至关重要.
研究的目的:
- 评估POEM后阿喀拉西亚患者真正酸性反流的发生率和危险因素.
- 为了区分真正的酸反流与非反流酸化模式.
- 为了确定那些可以从酸性抑制和基因组复制中受益的患者.
主要方法:
- 54名接受POEM治疗的阿喀拉西亚患者的前性队列研究.
- 手动分析pH跟踪,以确定真正的酸性反流和非反流酸化.
- 用症状问卷进行验证,食管胃镜检查,测力测量和计时的食管图.
主要成果:
- POEM显著改善了埃卡德得分 (6.7至1.6).
- 真正的酸性反流在29.6%的患者中被观察到,而自动化分析则为64.8%.
- 酸性发酵是最常见的非反流性酸化模式 (42.7%).
- 年龄的增加 (OR 1.12) 和手术前综合放松压力 (IRP) (OR 1.13) 是真正的酸性反流的重要危险因素.
结论:
- 手动pH跟踪审查对于识别在阿喀拉西亚中POEM后真正的酸性反流是必不可少的.
- 程序前的IRP是识别患有真正酸性反流风险的患者的预测因素.
- 这有助于量身定制治疗策略,以后的POEM achalasia患者.
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