射频治疗胃食管反流病70例报告  

Report of 70 patients with gastroesophageal reflux(GERD) disease treating by Stretta radiofrequency

作　　者：汪忠镐[1] 刘建军[2] 吴继敏[2] 王利营[2] 陈秀[2] 巩燕[2] 白晶[2] 董元元[2] 胡亚辉[2] 孙潮涌[2] 

机构地区：[1]首都医科大学宣武医院胸心血管外科,北京100053 [2]解放军第二炮兵总医院

出　　处：《临床外科杂志》2007年第6期404-406,共3页Journal of Clinical Surgery

摘　　要：目的 探讨胃食管反流病（GERD）临床表现及内镜下食管微量射频治疗疗效。方法对70例胃食管反流病患者,予24h胃食管pH监测、食管测压、胃镜检查,并在内镜下施行射频治疗。结果 19例以反酸、烧心、嗳气、呕吐等消化道症状为主;48例表现为咳嗽、咳痰、喘息等呼吸道症状为主,3例表现为胸骨后或后背部疼痛诊为冠心病;胃镜见贲门口松弛56例（80%）,仅20例（28.6%）有反流性食管炎;24h胃食管pH监测63例,见轻度酸反流18例（28.6%）,中度18例（28.6%）,重度21例（33.3%）,无酸反流6例（9.6%）;食管测压检查58例,见食管下段括约肌（LES）静息压力低下33例（56.9%）,正常25例;所有患者在治疗后立即复查胃镜,65例贲门口包绕内镜紧密,5例较前缩紧。随访60例6-12个月,50例明显缓解,以呼吸道为主要表现者尤为明显,7例有所缓解,2例复发（其中1例已再次治疗,哮喘又立即消失）,1例一直认为治疗不满意。结论 射频用于GERD患者的治疗常起到立竿见影的缓解作用,方法相对简捷、价廉、安全,对诊断明确的以呼吸道症状为主要表现的GERD患者特别值得提倡。似乎有必要提出由反流所引起的发生在胃食管交接处、咽、口鼻腔和喉气道的一个临床症候群,胃食管-喉气管综合征。Objective To explore clinical presentations of patients with gastroesophageal reflux disease （GERD） and evaluating the effect and efficacy of the Stretta radiofrequency treatment. Methods Analyzing material from 70 patients with GERD having a follow- up of more than 6 months. Results Nineteen patients with mainly acid reflux and heartburn;48 patients had predominate respiratory distresses,mostly diagnosed as asthma; 3 had retrostemal or back diagnosed as coronary disease. Gastroscopy found a patulous cardia in 56 cases （80 % ）, only 20 cases （28.6 % ）had reflux esophagitis; 24 hour esophageal acid monitoring revealed reflux in 90.4 %. Sixty patients had a follow- up period from 6--12 months, among them 50 patients had remarkable relieve especially for those with respiratory distresses, 7 had relieve,2 had recurrence （one had already a redo and an immediate disappearance effect of ＂asthma＂ was again obtained） and one felt no effect. Conclusion Quite a number of patients with ＂asthma＂ causes by GERD for long and the rediofrequency plays an immediately relieving effect in most of them. The Stretta radiofrequency is a relatively simple,safe and effective means to treat GERD patients especially suitable for those with respiratory distresses. It seems worth raising a new concept of gastroesophago- laryngotracheal syndrome which consists of a series of clinical presentations occurring at the gastroesophageal junction, pharynx,oronasal cavity and laryngotracheal tract purely due to reflux.

关 键 词：胃食管反流病 Stretta射频治疗 哮喘 胃食管喉气管综合征 

分 类 号：R655[医药卫生—外科学]