胃と腸59巻9号

2024年09月発行

今月の主題 食道運動障害の診断と治療 主題

食道運動障害に対する薬物治療およびバルーン拡張術

著者： 眞部紀明¹ 武家尾恵美子¹ 小西貴子¹ 中村純¹ 綾木麻紀¹ 藤田穰¹ 畠二郎¹ 春間賢²

所属機関： ¹川崎医科大学検査診断学（内視鏡・超音波） ²川崎医科大学総合内科学2

ページ範囲：P.1229 - P.1238

要旨●食道運動障害患者によくみられる嚥下困難感症状は，患者の生活の質に多大な影響を及ぼし，特に高齢者ではフレイルのみならず誤嚥性肺炎の要因にもなるため，その診断および治療が重要である．高解像度食道内圧検査（HRM）機器の開発と内視鏡的筋層切開術（POEM）を含む新規内視鏡治療手技の開発により，最近の20年でその診療は大きく進歩した．食道運動障害の中でも食道アカラシアは最も診断および治療法の進歩した疾患であり，現在，HRMで分類したサブタイプ別の治療方針が提案されている．一方，食道アカラシア以外の食道運動障害に対する治療法については，いまだ薬物治療を含めて定まったものがなく，今後解決すべき重要臨床課題である．

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