摘要
目的 总结小儿贲门失弛缓症的诊疗经验。方法 1980～ 1999年收治的 11例患儿 ,其临床症状均有吞咽困难 ,进食后呕吐 ,食管吞钡见食管下端鸟咀样狭窄等典型症状体征。所有病例均经胸或腹作了Heller手术 ,术中胃粘膜、食管粘膜破损各 1例。仅 1例同时作了抗反流手术。结果11例患儿手术后均顺利恢复 ,近期无并发症。获随诊的 7例 ,2例在吞食固体食物过快时有食物通过感。食管吞钡复查的 5例 ,食管腔光滑 ,无狭窄 ,钡剂通过顺畅 ,但 1例平卧有轻度反流。结论 小儿贲门失弛缓症的症状和X线征与成人相似。X线检查时作录像观察有助于提高新生儿病例的确诊率。弥漫性食管痉挛及狭窄段较长者宜经胸手术。
Objective To summarize the experiences of the diagnosis and treatment for achalasia of cardia in children.Methods Eleven patients with achalasia were admitted between Oct.1980 and July, 1990. There were 10 boys and 2 girls. All patients presented with typical manifestations such as dysphagia, vomit after feeding and bird-beak like stricture at lower esophagus on barium meal study. All patients underwent Heller operations transabdominally or transthoracically. Intra-operatively, one patient sustained damage of gastric mucosa and one esophageal mucosa. Only one patient had anti-reflux procedure simultaneously.Results All the 11 patients recovered well with no immediate complications. Seven patients have been followed-up. Among them, 2 patients felt discomfort while taking solid foods. Six patients had barium meal examinations. The results showed that all their esophageal lumens were smooth with no stricture, and the barium passed smoothly, while one had mild reflux on supine position. Conclusions Symptoms and radiological findings of achalasia in children are similar to that of adults. Video study during x-ray examination may be helpful to the diagnosis in neonates. For patients with diffuse esophageal spasm or long segment of stricture, transthoracic esophagocardiomyotomy are recommended.
出处
《中华小儿外科杂志》
CSCD
北大核心
2001年第5期284-285,共2页
Chinese Journal of Pediatric Surgery
