内镜下抗反流黏膜切除术和贲门缩窄术治疗胃食管反流病的临床疗效对比
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郑州大学第一附属医院消化内科

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河南省科技厅科技发展计划项目(162102310524)


Comparison of anti-reflux mucosectomy and endoscopic cardial constriction ligation on treatment of gastroesophageal reflux disease
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The First Affiliated Hospital of Zhengzhou University

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Science and Technology Development Project of Henan Provincial Science and Technology Department (162102310524)

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    摘要:

    目的 对比内镜下抗反流黏膜切除术(anti-reflux mucosectomy,ARMS)和贲门缩窄术(endoscopic cardial constriction ligation,ECCL)治疗胃食管反流病的临床疗效。方法 回顾性分析2015年12月—2018年8月在郑州大学第一附属医院行ARMS或ECCL治疗,并定期随访的48例胃食管反流病患者病例资料,其中20例行ARMS(ARMS组),28例行ECCL(ECCL组),比较两种术式短期及长期临床疗效。结果 两种术式的操作成功率均为100.0%,ECCL组手术时间明显短于ARMS组[(8.43±1.59)min比(34.05±12.35)min,t=-9.227,P<0.001]。术后2个月随访,ECCL组和ARMS组症状改善有效率分别为89.3%(25/28)和60.0%(12/20),差异有统计学意义(χ2=4.128,P=0.042),ECCL组GERD Q评分低于ARMS组[(6.24±1.22)分比(7.35±1.79)分,t=-2.400,P=0.023]。术后1年随访,两组症状改善有效率、GERD Q评分,以及DeMeester评分和pH<4时间百分比差异均无统计学意义(P>0.05)。结论 ARMS和ECCL治疗胃食管反流病的长期临床疗效相当,但ECCL短期疗效更具优势。

    Abstract:

    Objective To compare the clinical efficacy of anti-reflux mucosectomy (ARMS) and endoscopic cardial constriction ligation (ECCL) on treatment of gastroesophageal reflux disease. Methods A retrospective study was conducted on the data of 48 consecutive patients with gastroesophageal reflux disease, who underwent ARMS or ECCL at the First Affiliated Hospital of Zhengzhou University from December 2015 to August 2018. Twenty cases were in the ARMS group and 28 cases in the ECCL group. The short-term and long-term efficacies were compared between the two groups. Results The success rate of operation was 100.0% in the both groups. The operation time of the ECCL group was significantly shorter than that of the ARMS group (8.43±1.59 min VS 34.05±12.35 min, t=-9.227, P<0.001). After 2 months follow-up, the symptom improvement rate of the ECCL group and the ARMS group was 89.3% (25/28) and 60.0% (12/20), respectively (χ2=4.128, P=0.042). The GERD Q score of the ECCL group was significantly lower than that of the ARMS group (6.24 ±1.22 VS 7.35±1.79, t=-2.400, P=0.023). One year after operation, there were no significant differences in the symptom improvement rate, GERD Q score, DeMeester score and the time percentage of pH<4 between the two groups (P>0.05). Conclusion The long-term clinical effect of ARMS and ECCL is similar, but the short-term clinical effect of ECCL is superior to ARMS.

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贺德志,郑研艳,王小彤,等.内镜下抗反流黏膜切除术和贲门缩窄术治疗胃食管反流病的临床疗效对比[J].中华消化内镜杂志,2020,37(8):553-557.

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  • 收稿日期:2019-10-16
  • 最后修改日期:2020-07-01
  • 录用日期:2019-11-19
  • 在线发布日期: 2020-08-26
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