在口腔内镜肌切除术后,反流食道炎的发生率和危险因素
Elise M Wessels1,2, Gwen M C Masclee1,2, Barbara A J Bastiaansen1,2
1Department of Gastroenterology & Hepatology, Amsterdam Gastroenterology and Metabolism, University Medical Centers Amsterdam, Amsterdam, the Netherlands.
Neurogastroenterology and motility
|April 8, 2024
概括
门内镜性肌肉切除 (POEM) 治疗阿喀拉西亚经常导致逆流食道炎,影响52%的患者. 识别肌肉切割的长度和酒精使用等危险因素可以指导预防策略.
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
- 胃食道逆流性疾病 胃食道逆流性疾病
背景情况:
- 口腔内镜肌切除术 (POEM) 是一种被公认的治疗阿喀拉西亚的方法.
- 后POEM胃食道逆流性疾病 (GERD) 是一个常见的并发症.
- 了解POEM后逆流食道炎的发生率和预测因素至关重要.
研究的目的:
- 为了确定POEM后反流食道炎的发生率和严重程度.
- 为了确定预测POEM后逆流食道炎的发展的因素.
主要方法:
- 在2011年8月至2022年12月期间接受POEM的252名患者的回顾性分析.
- 使用多变量后勤回归来确定反流性食道炎的预测因素.
主要成果:
- 反流性食道炎发生在POEM一年内52%的患者中,12%的患者患有严重的食道炎 (LA等级C/D).
- 逆流食道炎的预测因素包括更长的肌肉切割长度,更高的POEM前Eckardt分数,以及先前的气动扩张或腹腔镜赫勒肌肉切割 (LHM).
- 酒精消费和超重 (BMI ≥25 kg/m2) 与风险增加有关,而之前的LHM对严重的反流食道炎有保护作用.
结论:
- 大约一半的患者在POEM后患上逆流食道炎,很大一部分是严重的.
- 识别这些预测因素有助于患者选择POEM.
- 根据已识别的风险因素,可以启动积极的预防措施或预防性治疗.
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