| BackgroundAchalasia of the esophagus is a very rare neurogenic motility disorder of the esophagus,with an estimated annual incidence of 0.11:100,000 cases overall.AC is directly related to the stop of esophageal peristalsis,the pressure of lower esophageal sphincter(LES)increasing and the pressure of LES releasing disorder,and led to a series of clinical symptoms,such as dysphagia,weight loss,reflux,and chest pain.The quality of life in patients was seriously affected and long-term esophageal sphincter can not relax,resulting in food retention in the esophagus,easy to stimulate the esophageal mucosa,bleeding,inflammation,and even ulcer,a few people may appear cancerous.Peroral endoscopic myotomy(POEM)is first developed by Inoue,who applied to the technique in adult humans,and the technique represented another innovation in the minimally invasive approach to achalasia,which was rapidly and widely adopted,with very large series being reported within a few years.Previous studies on achalasia and POEM mainly focus on POEM's operation time,average hospital stay,pressure changes of LES,and postoperative complications.As a chronic disease,AC is closely related to its symptoms and mood,but the relationship between mood and AC has not been widely studied,and there are few relevant studies at home and abroad.This study evaluates the anxiety level of AC patients,aiming to conduct a systematic study of anxiety-related clinical factors,and explore the effect of POEM on negative emotions and clinical symptoms of patients.ObjectiveTo investigate the risk factors causing anxiety in patients with achalasia cardia,and to analyze the effect of POEM on anxiety and clinical symptoms.MethodsFrom March 2017 to September 2018,41 hospitalized patients with achalasia cardia at the first affiliated hospital of zhengzhou university.(1)general information: age,body mass index,work intensity,living habits and other indicators were calculated in the form of questionnaire.(2)clinical symptom score: the preoperative and postoperative clinical symptoms in patients with achalasia,including weight loss,chest pain,dysphagia and reflux.The score was given according to the actual situation and combined with the scoring system.(3)The anxiety self-assessment scale: patients with achalasia answered the questions in the scale according to the situation,and according to the anxiety self-assessment scale was divided with or without anxiety.(4)SPSS 21.0 was used to assign and input experimental data.First,the differences in various indicators between the anxious group and the non-anxious group were compared.Measurement data conforming to the normal distribution are represented by mean and standard deviation(x±s),T-test or chi-square test was used for comparison between groups,and P<0.05 was considered statistically significant.Then risk factors with P < 0.1 were selected and Logistic regression was used to analyze the relationship between each indicator and anxiety.Meanwhile,comparing the difference between the anxiety scores and clinical symptoms before and after POEM treatment.ResultsBMI,duration of disease and preoperative Eckardt score were statistically different between the two group(P<0.05).In the multivariate Logistic regression analysis,duration of disease(OR =1.68,P=0.034)and preoperative Eckardt score(OR =2.35,P=0.047)were independently associated with anxiety in patients with achalasia.Meanwhile,Before POEM,Anxiety score of patients with achalasia was51.4±16.4,which was 35.6±11.3 at one month after operation,Eckardt score was of patients with achalasia 5.8±1.9,which was 1.2±0.6 at one month after operation.Compared with that before operation,the clinical symptoms and anxiety were significantly improve.ConclusionsThe quality of life in patients with achalasia was poor,and duration of disease and preoperative Eckardt score were important factors influencing anxiety,POEM can remarkably improve the quality of life in patients with patients with achalasia. |
PDF Full Text Request