摘要
目的评价抗反流黏膜切除术治疗胃食管反流病的临床有效性和安全性。方法2015年12月至2018年7月,郑州大学第一附属医院消化内科行抗反流黏膜切除术的18例胃食管反流病病例资料纳入回顾性研究,统计治疗效果(治疗后烧心及反流症状改善情况、24 h食管pH监测结果等)以及并发症发生情况。结果18例均成功进行了抗反流黏膜切除术,操作成功率为100%,其中8例行ESD、10例行EMR。24 h食管pH监测结果显示,治疗后Demeester评分、pH<4时间百分比、总反流事件、pH<4时间长于5 min的反流次数较术前均明显降低[(20.16±9.12)分比(74.16±20.03)分、(2.70±0.88)%比(6.42±1.37)%、(43.78±19.68)次比(156.56±41.22)次、(2.89±1.68)次比(9.89±2.95)次,P均<0.05]。无术后出血、穿孔、感染病例。随访3~34个月,烧心及反流症状改善总有效率为89%(16/18)。胃镜随访显示18例贲门均较前缩紧,收缩良好;16例反流性食管炎较前明显好转,黏膜糜烂愈合。结论抗反流黏膜切除术治疗胃食管反流病安全有效,且简单易行。
Objective To assess the efficacy and safety of the endoscopic anti-reflux mucosectomy for gastroesophageal reflux disease. Methods Data of 18 patients with gastroesophageal reflux disease who underwent endoscopic anti-reflux mucosectomy at the First Affiliated Hospital of ZhengZhou University from December 2015 to July 2018 were retrospectively studied. The therapeutic effects (improvement of heartburn and reflux symptoms, 24 h esophageal pH monitoring) and complications were analyzed. Results Anti-reflux mucosectomy was performed successfully in all patients with successful rate of 100%. ESD was performed in 8 cases and EMR in 10 cases.24 h esophageal pH monitoring results showed that the Demeester score, the time percentage of pH < 4, total reflux events and reflux times of pH < 4 with time longer than 5 minutes after treatment were significantly lower than those before treatment (20.16±9.12 VS 74.16±20.03,(2.70±0.88)% VS (6.42±1.37)%, 43.78±19.68 VS 156.56±41.22, 2.89±1.68 VS 9.89±2.95, all P<0.05). No bleeding, perforation or infection was observed after the procedure. During a follow-up period of 3-34 months, symptom relief rate was 89%(16/18). A tightened cardiac was noted in 18 cases and recovery of mucosal damage was found in 16 patients. Conclusion Anti-reflux mucosectomy is safe, effective and easy to operate for gastroesophageal reflux disease.
作者
贺德志
王小彤
刘冰熔
李建生
刘丹
郑璞
郑研艳
陈杨
He Dezhi;Wang Xiaotong;Liu Bingrong;Li Jiansheng;Liu Dan;Zheng Pu;Zheng Yanyan;Chen Yang(Department of Gastroenterology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)
出处
《中华消化内镜杂志》
CSCD
北大核心
2019年第9期682-685,共4页
Chinese Journal of Digestive Endoscopy
基金
河南省医学科技攻关计划项目(201602028)
河南省科技厅科技发展计划项目(162102310524).
关键词
胃食管反流
抗反流黏膜切除术
内镜治疗
Gastroesophageal reflux
Anti-reflux mucosectomy
Endoscopic therapy
