抗反流黏膜切除术治疗胃食管反流病的临床疗效观察
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1.郑州大学第一附属医院;2.郑州大学第一附属医院消化内科

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基金项目:

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)


Clinical evaluation of endoscopic anti-reflux mucosectomy for gastroesophageal reflux disease
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Affiliation:

The First Affiliated Hospital of Zhengzhou University

Fund Project:

Henan Provincial Medical Science and Technique Foundation(201602028); Science and Technology Development Project of Henan Provincial Science and Technology Department(162102310524)

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    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。

    Abstract:

    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.

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贺德志,王小彤,刘冰熔,等.抗反流黏膜切除术治疗胃食管反流病的临床疗效观察[J].中华消化内镜杂志,2019,36(9):682-685.

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  • 收稿日期:2018-11-07
  • 最后修改日期:2019-07-19
  • 录用日期:2018-12-06
  • 在线发布日期: 2019-09-25
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