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目的探讨儿童贲门失弛缓症的临床特点及治疗方法。方法分析我院2008年6月至2016年3月确诊的21例贲门失弛缓症患儿的临床表现、检查及治疗情况。结果男15例,女6例,就诊时年龄7个月至16岁9月,病程40 d至4年,呕吐和吞咽困难是最多见的症状,其次为咳嗽、反酸、胸骨后疼痛、体重增长缓慢等。根据临床表现,结合消化道造影、电子胃镜、食管高分辨测压等诊断,治疗包括口服硝苯地平、胃镜下食管球囊扩张术和经口内镜下食管括约肌切开术(POEM)、开胸及腹腔镜下食管下段肌层切开术(Heller手术)。结论消化道造影是诊断本病的主要方法,食管高分辨测压可对本病进行分型和手术疗效评估,腹腔镜下Heller手术+胃底折叠术和POEM术损伤小、恢复快、手术效果显著,是本病较好的治疗方法。
Objective To investigate the clinical features and treatment of achalasia in children. Methods The clinical manifestations, examination and treatment of 21 children with achalasia diagnosed in our hospital from June 2008 to March 2016 were analyzed. Results There were 15 males and 6 females, ranging in age from 7 months to 16 years at the time of treatment. The duration of 40 days to 4 years was the most common symptom. Vomiting and dysphagia were the most common symptoms, followed by cough, acid reflux, sternal pain, Slow growth and so on. According to clinical manifestations, combined with gastrointestinal imaging, electronic endoscopy, esophageal high-resolution manometry and other diagnosis and treatment, including oral nifedipine, endoscopic esophageal balloon dilatation and endoscopic esophageal sphincterotomy (POEM), open Chest and laparoscopic esophageal myomectomy (Heller surgery). Conclusions Gastrointestinal angiography is the main method to diagnose this disease. Esophageal high-resolution manometry can be used to evaluate the classification and operation of this disease. Laparoscopic Heller surgery + fundoplication and POEM have less injury and quick recovery. Significantly, this disease is a better treatment.