食管-贲门失弛缓症诊断与治疗（Diagnosis and treatment of achalasia of esophagus and cardia）.docVIP

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食管-贲门失弛缓症诊断与治疗（Diagnosis and treatment of achalasia of esophagus and cardia）.doc

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食管-贲门失弛缓症诊断与治疗（Diagnosis and treatment of achalasia of esophagus and cardia）

食管-贲门失弛缓症诊断与治疗（Diagnosis and treatment of achalasia of esophagus and cardia） Diagnosis and treatment of achalasia of esophagus and cardia Update Date: 12-07 #e# esophageal achalasia (Esophageal, achalasia) is a disorder caused by esophageal neuromuscular dysfunction. The main feature is the lack of peristalsis in the esophageal body and the relaxation of the lower esophageal sphincter (lower, esophageal, sphincter, LES). The incidence of this disease is about 1.0/10 million, the age of onset is 13~77 years old, the most common in the age group of 20~39 years old, the incidence of men and women is similar, accounting for 4% to 7% of esophageal diseases [1]. 1 etiology and pathogenesis Achalasia is now a neurogenic disease. The number of ganglion cells of esophageal body nerve decreased, while esophageal branch of vagus nerve showed degenerative changes, the motor nucleus of the vagus nerve ganglion cells in brain ridge also decreased, and the decrease of vagus nerve stimulation and cholinergic drug response. 2 pathology The basic lesion of this disease is the degeneration of the myenteric plexus, the ganglion cell of the Auerbach nerve plexus and the motor nucleus of the vagus nerve [2]. The extent of the above injuries varied and correlated with the duration and severity of dyskinesia. In addition, the vagus nerve fibers of the esophageal plexus are associated with the myenteric plexus, and the nerve fibers in the wall also undergo degeneration. 3 clinical features 3.1 dysphagia, painless dysphagia, the disease is the most common, the earliest symptoms, accounting for 80% to 95% above [1]. Symptoms are mostly intermittent attacks, due to emotional agitation, anxiety, eating cold and spicy and other stimulating food and induced. Light weight at the beginning may be persistent in the later stage. Most patients swallow solids more difficult or less difficult than liquids, but a small number of swallowing fluids are more difficult than solids. 3.2 chest pain accounted f