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J Gastroenterology: 经口内镜下肌切开术治疗儿童门失弛缓症的安全性和有效性分析

2020-01-18 不详 MedSci原创

经口内镜下肌切开术(POEM)在治疗成人门失弛缓症方面已显示出优异的结果,但对儿童的研究却很有限。本研究旨在分析儿童经口内镜下肌切开术(POEM)的结果,并在大型多中心研究中与成人结果进行比较。

背景
经口内镜下肌切开术(POEM)在治疗成人门失弛缓症方面已显示出优异的结果,但对儿童的研究却很有限。本研究旨在分析儿童经口内镜下肌切开术(POEM)的结果,并在大型多中心研究中与成人结果进行比较。

方法
研究人员回顾性分析在三个三级中心接受POEM的连续性门失弛缓患者的临床数据。本研究共包括130名儿童。主要观察结局是围手术期结果。

结果
1名儿童(0.8%)遇到技术故障。5名儿童(3.8%)有重大不良事件,包括1名发生气胸,2名粘膜屏障功能障碍延迟,1名再次入院和1名生命体征不稳定。儿童的POEM术后Eckardt评分和中位LES压力均显着低于其POEM之前的参考值(0.7 vs 7.4; 7.0 vs 27.1 mmHg;P<0.001)。在40个月的中位随访期间,儿童的临床返流率为27.0%,在1、3和5岁时的临床失败率为1.8%,3.5%和4.4%。儿童和成人之间的技术衰竭,主要不良事件和术后临床反流情况相当(所有P> 0.05)。Kaplan–Meier分析表明,儿童的临床失败风险低于成人(危险比= 0.37,95%置信区间0.15–0.91,P= 0.023)。

结论
在患有门失弛缓症的儿童中,POEM可以安全地进行,并且与成年人相比,在长期随访期间可以产生更好的临床反应。

原始出处:

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  5. [GetPortalCommentsPageByObjectIdResponse(id=2064953, encodeId=57a1206495325, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Feb 06 11:46:00 CST 2020, time=2020-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2066652, encodeId=6bb5206665243, content=<a href='/topic/show?id=1d3d45e090e' target=_blank style='color:#2F92EE;'>#安全性和有效性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45709, encryptionId=1d3d45e090e, topicName=安全性和有效性)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/E33DC517C2EC449E463E3D01D81745BA/100, createdBy=75e12500157, createdName=ms1756883563247400, createdTime=Tue Jan 21 10:46:00 CST 2020, time=2020-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742210, encodeId=51651e422109c, content=<a href='/topic/show?id=8699e824797' target=_blank style='color:#2F92EE;'>#经口内镜下肌切开术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78247, encryptionId=8699e824797, topicName=经口内镜下肌切开术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9adf35051969, createdName=bioon13, createdTime=Sat Aug 22 05:46:00 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712279, encodeId=c9041e1227962, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Feb 26 07:46:00 CST 2020, time=2020-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072861, encodeId=388920e2861a5, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Fri Oct 23 20:46:00 CST 2020, time=2020-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262156, encodeId=b2fe12621567d, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Mon Jan 20 00:46:00 CST 2020, time=2020-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504898, encodeId=4bb115048983a, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Mon Jan 20 00:46:00 CST 2020, time=2020-01-20, status=1, ipAttribution=)]
    2020-10-23 许安
  6. [GetPortalCommentsPageByObjectIdResponse(id=2064953, encodeId=57a1206495325, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Thu Feb 06 11:46:00 CST 2020, time=2020-02-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2066652, encodeId=6bb5206665243, content=<a href='/topic/show?id=1d3d45e090e' target=_blank style='color:#2F92EE;'>#安全性和有效性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45709, encryptionId=1d3d45e090e, topicName=安全性和有效性)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/1103841572/E33DC517C2EC449E463E3D01D81745BA/100, createdBy=75e12500157, createdName=ms1756883563247400, createdTime=Tue Jan 21 10:46:00 CST 2020, time=2020-01-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1742210, encodeId=51651e422109c, content=<a href='/topic/show?id=8699e824797' target=_blank style='color:#2F92EE;'>#经口内镜下肌切开术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=78247, encryptionId=8699e824797, topicName=经口内镜下肌切开术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9adf35051969, createdName=bioon13, createdTime=Sat Aug 22 05:46:00 CST 2020, time=2020-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1712279, encodeId=c9041e1227962, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Feb 26 07:46:00 CST 2020, time=2020-02-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072861, encodeId=388920e2861a5, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Fri Oct 23 20:46:00 CST 2020, time=2020-10-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262156, encodeId=b2fe12621567d, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c30265, createdName=jiafufeng@yaho, createdTime=Mon Jan 20 00:46:00 CST 2020, time=2020-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504898, encodeId=4bb115048983a, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Mon Jan 20 00:46:00 CST 2020, time=2020-01-20, status=1, ipAttribution=)]
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