目的:探讨高分辨率食管测压(high resolution esophageal manometry，HREM)评估贲门失弛缓症(achalasia of cardia, AC)儿童经口内镜下肌切开术(peroral endoscopic myotomy, POEM)效果的作用。方法:收集2013年1月—2019年9月于西安市儿童医院行POEM治疗的30例AC患儿资料。患儿分别于POEM治疗前及治疗后6个月行HREM。比较术前与术后患儿食管下括约肌静息压(lower esophageal sphincter pressure, LESP)、4 s完整松弛压(4-second integrated relaxation pressure, 4sIRP)、Eckardt症状评分及营养状况。结果:行POEM治疗的AC患儿年龄4～14岁。LESP术后为(5.50±1.13)mmHg(1 mmHg＝0.133 kPa)，较术前的(26.23±4.47)mmHg明显降低，差异有统计学意义(n t＝-24.623，n P<0.001)；术后中位4sIRP为5 mmHg，较术前的25 mmHg降低20 mmHg，差异有统计学意义(n Z＝-4.786，n P<0.001)。术后中位Eckardt症状评分为1分，较术前的8分显著下降，差异有统计学意义(n Z＝-4.796，n P<0.001)；患儿的营养状况由术前的重度营养不良明显改善至正常(n Z＝-5.166，n P<0.001)。n 结论:POEM治疗能显著改善AC患儿的食管动力学特征，HREM可作为AC患儿POEM术后随访评估的重要客观指标。“,”Objective:To evaluate high resolution esophageal manometry (HREM) in peroral endoscopic myotomy (POEM) for pediatric achalasia of cardia (AC).Methods:Data of 30 AC children who received POEM in Xi′an Children′s Hospital from January 2013 to September 2019 were reviewed. HREM was performed before and 6 months after POEM. Preoperative and postoperative lower esophageal sphincter pressure (LESP), 4-second integrated relaxation pressure (4sIRP), Eckardt scores and nutritional status were compared.Results:Children with AC aged between 4-14 years. Postoperative LESP was 5.50±1.13 mmHg (1 mmHg=0.133 kPa), which was significantly lower than that before operation (26.23±4.47 mmHg) with significant difference (n t=-24.623, n P<0.001). Postoperative median 4sIRP was 5 mmHg, which was 20 mmHg lower than that before operation (25 mmHg) with significant difference (n Z=-4.786, n P<0.001). Postoperative median Eckardt symptom score decreased significantly compared with that before (1 VS 8,n Z=-4.796, n P<0.001). Severe malnutrition of the AC children improved evidently to normal(n Z=-5.166, n P<0.001).n Conclusion:POEM can significantly improve the characteristics of esophageal dynamics in children with AC, and HREM can be an important indicator for follow-up evaluation of POEM.