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首页> 美国卫生研究院文献>BMJ Case Reports >Case Report: Cricopharyngeal myotomy for cricopharyngeus stricture in an inclusion body myositis patient with hiatus hernia: a learning experience
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Case Report: Cricopharyngeal myotomy for cricopharyngeus stricture in an inclusion body myositis patient with hiatus hernia: a learning experience

机译：病例报告：伴有裂孔疝的包涵体肌炎患者的环咽肌切开术治疗环咽狭窄：一种学习经验

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摘要

Inclusion body myositis is a chronic progressive myopathy which tends not to respond to steroids and immunosuppressive treatments. Dysphagia is more common in this group than other inflammatory myopathies like polymyositis and dermatomyositis. Otolaryngologists are involved in the management of dysphagia in inclusion body myositis. They usually use a combination of cricopharyngeal myotomy, upper oesophageal dilation or botulinum injection to help with the symptoms. Cricopharyngeus myotomy is the preferred treatment in this group and patients tend to be discharged after a short stay in the hospital. However, our experience was completely different from what we expected as a relatively straightforward procedure led to severe morbidity and prolonged hospital admission due to continuous acid reflux and aspiration. We believe that the presence of hiatus hernia led to this problem as the patient's problem resolved completely after her hernia was treated.
机译：包涵体肌炎是一种慢性进行性肌病，对类固醇和免疫抑制疗法无反应。与其他炎症性肌病（例如多肌炎和皮肌炎）相比，吞咽困难在这一组中更为常见。耳鼻喉科医生参与包涵体肌炎吞咽困难的治疗。他们通常结合使用环咽肌切开术，上食道扩张或肉毒杆菌注射来缓解症状。 Cricopharyngeus肌切开术是该组的首选治疗方法，患者短期住院后往往会出院。但是，我们的经验与我们预期的完全不同，因为相对较简单的手术会由于持续的酸反流和误吸而导致严重的发病率并延长住院时间。我们相信，裂孔疝的存在导致了这个问题，因为患者的疝气在治疗后完全解决了。

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