摘要
目的探讨腹腔镜引导下修补术治疗食管裂孔疝(HH)疗效及对患者生活质量的影响,为临床治疗提供依据。方法收集2006年1月-2012年1月在该院收治的80例HH患者作为研究对象。随机分为对照组40例和观察组40例,对照组给予腹腔镜引导下修补术加Nissen胃底折叠术治疗,观察组给予腹腔镜引导下修补术加Dor胃底折叠术治疗。比较两组HH患者手术状况、抗反流效果、术后不良反应及生活质量。结果观察组术中出血量明显少于对照组,手术时间及住院时间明显短于对照组患者,均P<0.05,差异均有统计学意义。两组患者治疗后食管下端括约肌压(LESP)均明显升高,Demeester评分均明显降低,均P<0.05,差异均有统计学意义;但治疗后两组患者LESP和Demeester评分差异无统计学意义。观察组患者术后吞咽困难与进食后腹胀发生率明显低于对照组患者,均P<0.05,差异均有统计学意义。两组患者术后生活质量较治疗前明显提高,均P<0.05,差异具有统计学意义;观察组术后生理功能状态评分与消化病生存质量指数(GLQI)总分明显高于对照组术后,均P<0.05,均差异有统计学意义。结论腹腔镜引导下修补术联合Dor胃底折叠术治疗食管裂孔疝具有显著疗效,并且术后不良反应较少,可显著提高患者生活质量,值得在临床上进一步研究。
【Objective】To investigate the clinical effect of laparoscopic repair and its impact on quality of life in patients with hiatal hernia（HH） and provide clinical basis for HH therapy.【Methods】From 2006/1 to 2012/1, we collected 80 HH cases in our hospital and divided them into 2 groups randomly, 40 cases in control group and 40 cases in observation group. The control group was treated with laparoscopic repair and Nissen fundoplication and the observation group was treated with laparoscopic repair and Dor fundoplication. Before and after treatment, the surgery situation, antireflux effect, side effects, and quality of life were observed and compared. 【Results】The observation group had less amount of bleeding, less time of operation and stay of hospital than those of the control group, P〈0.05, and all differences were statistically significant. LESP increased and Demeester score decreased in Both 2 groups after treatments, but they had no significant difference between 2 groups. Both incidences of dysphagia and abdominal distension after intake were lower in the observation group than in the control group, P〈0.05,the differences were statistically significant. Both quality of life of 2 groups were improved after treatments, but the physiological state score and Gastrointestinal Life Quality Index were higher than those of the control group after treatments, P〈0.05, all the differences were statistically significant. 【Conclusion】Laparoscopic repair and Dor fundoplication are efficient and can improve the quality of life significantly. They are worthy of further study in clinical treatment.
出处
《中国内镜杂志》
北大核心
2015年第10期1065-1068,共4页
China Journal of Endoscopy
