摘要
目的:总结腹腔镜Nissen胃底折叠术后代谢性疾病改善的原因。方法:随访2009年6月至2010年12月34例胃食管反流、食管裂孔疝患者,采用门诊随访、电话随访及信件随访相结合的方式分别于术后1周、4周、3个月、6个月、12个月、18个月、24个月随访。随访内容包括体重、症状(反酸、烧心、吞咽困难、睡眠情况)、服用处方药种类及剂量变化等。术后1个月、6个月、12个月、24个月随访上消化道钡餐及胃镜检查。结果:34例患者中,16例伴有代谢性疾病,其中11例高血压、6例糖尿病、3例高血脂(2例患者同时有高血压、糖尿病,2例同时有高血压、高血脂);7例高血压、2例糖尿病及2例高血脂患者症状得到缓解(口服药减量甚至可以停药)。结论:Nissen胃底折叠术后代谢性疾病的改善机制仍不明确,可能原因有术后体重减轻、胃肠激素的改变、胃底的废用等,尚待进一步临床及实验室研究及大宗病例报道、多中心随访研究的证实。
Objective：To summarize the reasons of improvement of the metabolic diseases after laparoscopic Nissen fundoplica- tion. Methods：Thirty-four patients whose diagnosis were gastroesophageal reflux disease or hiatal hernia underwent laparoscopic opera- tions from Jun. 2009 to Dec. 2010, and were followed up at least 24 months. Outpatient follow-up, combination with telephone and letters were used. The follow-up included weight, symptoms （acid reflux, heartburn, dysphagia, sleep）, changes in the types and doses of pre- scription drugs. After 1 month,6 months, 12 months,24 months of operation, the patients had gastrointestinal barium meal and endosco- py. Results：Sixteen cases had metabolic problems in 34 patients, including 11 cases of hypertension,6 diabetes and 3 hyperlipidemia （2 patients at the same time had hypertension and diabetes ,2 patients had hypertension and hyperlipidemia）. A part of these patients＇ symptoms bad been alleviated （oral medication reduction or even discontinuation） including 7 patients with hypertension,2 cases with diabetes and 2 patients with hyperlipidemia. Conclusions：The mechanism of improvement of this group during follow-up after Nissen fundoplication is still unknown. It is proposed to contain some possible reasons, for example：postoperative weight loss, gastrointestinal hormone changes, useless of gastric fundus, which need further validation of the clinical and laboratory studies as well as the bulk of ca- ses, multi-center follow-up study.
出处
《腹腔镜外科杂志》
2014年第7期481-484,共4页
Journal of Laparoscopic Surgery
