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贲门失弛缓症:诊断、治疗和监测。

Achalasia: Diagnosis, Management and Surveillance.

机构信息

Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, 630 West 168th Street, Suite 3-401, New York, NY 10032, USA.

Division of Digestive and Liver Diseases, Columbia University Irving Medical Center, 630 West 168th Street, Suite 3-401, New York, NY 10032, USA.

出版信息

Gastroenterol Clin North Am. 2021 Dec;50(4):721-736. doi: 10.1016/j.gtc.2021.07.001. Epub 2021 Oct 2.

Abstract

Achalasia is a rare chronic esophageal motility disorder characterized by incomplete relaxation of the lower esophageal sphincter and abnormal peristalsis. This abnormal motor function leads to impaired bolus emptying and symptoms of dysphagia, regurgitation, chest pain, or heartburn. After an upper endoscopy to exclude structural causes of symptoms, the gold standard for diagnosis is high-resolution esophageal manometry. However, complementary diagnostic tools include barium esophagram and functional luminal impedance planimetry. Definitive treatments include pneumatic dilation, Heller myotomy with fundoplication, and peroral endoscopic myotomy.

摘要

贲门失弛缓症是一种罕见的慢性食管动力障碍性疾病,其特征为食管下括约肌不完全松弛和异常蠕动。这种异常的运动功能导致食团排空受损,并出现吞咽困难、反流、胸痛或烧心等症状。在上消化道内镜检查排除症状的结构性原因后,诊断的金标准是高分辨率食管测压。然而,补充性诊断工具包括食管钡剂造影和功能性腔内阻抗平面成像。明确的治疗方法包括气囊扩张、Heller 肌切开术加胃底折叠术以及经口内镜肌切开术。

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