摘要
目的:分析腹腔镜袖状胃切除手术前后的胃食管反流病,研究两者之间的关系。方法:2016年1月至2017年3月行袖状胃切除术61例。术前、术后1个月及6个月行GERD Q评分,术前和术后6个月行胃镜检查。结果:本研究所有病人均顺利完成手术,无严重并发症发生。术后1个月时多余体重减轻为42.65%,总体重减轻为11.69%;6个月时多余体重减轻为96.38%,总体重减轻为28.81%。术前存在GERD的病人14例(23%)。按BMI分级,Ⅰ°肥胖GERD的发生率为15.4%,Ⅱ°肥胖19.0%。Ⅲ°肥胖29.6%。术后1个月时35.7%缓解,6个月时64.3%缓解。未缓解的病人GERD Q评分也无明显升高。术后新发GERD在1个月时为59.6%,6个月时为34.0%。结论:腹腔镜袖状胃切除术后会出现新发GERD病人。术前存在GERD的病人不应成为手术的禁忌证。
Objective To analyze the association of gastric esophageal reflux disease（GERD） with laparoscopic sleeve gastrectomy by the comparison of GERD before and after gastrectomy. Methods From January 2016 to March 2017,61 patients underwent laparoscopic sleeve gastrectomy in this hospital. GERD Q scores were evaluated preoperatively, 1 month and 6 month postoperatively. Gastroscopy was performed before and 6 month after surgery. Results All patients completed the operation successfully without any severe complications. Excess weight loss was 42.65% and 96.38% 1 month and 6 month after operation respectively. Total weight loss was 11.69% and 28.81% 1 month and 6 month after operation respectively. There were 14（23%） patients of GERD with GERD Q score ≥8 preoperatively. According to BMI classification, preoperative GERD was 15.4% in degree Ⅰ obesity, 19% in degree Ⅱ and 29.6% in degree Ⅲ. The symptoms of patients with GERD were improved in 35.7% at 1 month and 64.3% at 6 month after operation. The GERD Q scores did not increase significantly after gastrectomy for the rest patients whose preoperative GERD symptoms were not improved. De novo of GERD was 59.6% patients at 1 month and 34.0% at 6 month after operation. Conclusions De novo of the patients with GERD was found after laparoscopic sleeve gastrectomy. Preoperative GERD should not be contraindicated of sleeve gastrectomy.
出处
《外科理论与实践》
2017年第6期493-498,共6页
Journal of Surgery Concepts & Practice
关键词
袖状胃切除术
胃食管反流病
病态肥胖
Sleeve gastrectorny
Gastroesophageal reflux disease
Morbidly obese
