论文部分内容阅读
目的:探讨小儿贲门失弛缓症的诊疗方法。方法:回顾性分析2001年9月—2011年9月收治的34例贲门失弛缓症患儿的临床资料,患儿均有吞咽困难,进食后呕吐胃内容物,上消化道钡餐检查可见食管下端鸟嘴样狭窄等典型征象。患儿均经腹行改良Heller术和Dor胃底前壁折叠术。结果:34例均于手术后7~14 d顺利出院,出院前均可进半流食。1例失访,33例患儿随访2个月至9年7个月。均无吞咽困难、进食后呕吐和反流性食管炎的症状,术后上消化道钡餐复查,食管腔光滑,狭窄段变粗,钡剂通过顺畅,且无胃食管反流征象。除1例21三体综合征患儿外,其余患儿生长发育与同龄儿相仿。结论:改良Heller术治疗小儿贲门失弛缓症具有良好的效果,附加Dor胃底前壁折叠术能够有效防止改良Heller术后的胃食管反流。
Objective: To investigate the diagnosis and treatment of achalasia in children. Methods: The clinical data of 34 children with achalasia treated in our hospital from September 2001 to September 2011 were retrospectively analyzed. All children had dysphagia, vomit stomach contents after ingestion, barium meal examination in the upper digestive tract revealed lower esophageal Nib-like narrow and other typical signs. All children underwent modified abdominal surgery Heller operation and Dor gastric anterior wall folds. Results: All the 34 cases were discharged smoothly from 7 to 14 days after operation. One case was lost to follow-up and 33 cases were followed up for 2 months to 9 years and 7 months. No dysphagia, symptoms of vomiting and reflux esophagitis after eating, postoperative upper gastrointestinal barium meal review, smooth esophageal lumen, thickening of the stricture, smooth passage of barium, and no signs of gastroesophageal reflux. In addition to a case of trisomy 21 children, the rest of children with similar growth and development of children. Conclusions: Modified Heller’s treatment of achalasia in children has a good effect. Additional anterior fundoplication of Dor fundus can effectively prevent gastroesophageal reflux after Heller operation.