[摘要] 目的 评价腹腔镜Heller术合并胃底折叠术(LHT)治疗贲门失弛缓症的疗效。方法 30例伴严重吞咽困难的贲门失弛缓症的患者实行了LHT。在手术前后均对症状和食管的功能进行评估。结果 患者吞咽困难的评分从术前10分下降至(1.7±1.2)。食管下端括约肌压力显著下降。仅3例患者出现酸反流。结论 LHT是非常有效的治疗贲门失弛缓症的方法，有助于降低食管下端括约肌压力和缓解患者的吞咽困难。

    [关键词] 贲门失弛缓症；腹腔镜手术；Heller平滑肌切开术；Toupet胃底折叠术

    Laparoscopic Heller myotomy with Toupet fundoplication for achalasia straightens the esophagus and relieves dysphagia

    YANG Liu-qing.Department of Surgery,the 330th Hospital of the People’s Liberation Army,Wuhan 430200,China

    [Abstract] Objective We assessed the usefulness of a laparoscopic Heller myotomy with a Toupet fundoplication (LHT) for the treatment of achalasia.Methods LHT was performed in 30 patients who had esophageal achalasia with severe dysphagia.Symptoms and esophageal function were evaluated before and after surgery.Results The dysphagia score decreased to 1.7 ± 1.2(±s) points from a preoperative value of 10.The lower esophageal sphincter pressure decreased significantly.Pathologic acid reflux was noted in 3 patients.Conclusion LHT is a useful procedure for straightening the esophagus,reducing lower esophageal sphincter pressure,and relieving dysphagia in patients with achalasia. ......