胃食管反流性疾病的腹腔镜胃底折叠术治疗  

Laparoscopic fundoplication for the treatment of severe gastroesophageal reflux disease

作　　者：秦鸣放 赵宏志 曹占国 

机构地区：[1]天津微创外科中心,天津300100

出　　处：《外科理论与实践》2007年第6期559-561,共3页Journal of Surgery Concepts & Practice

摘　　要：目的:探讨中、重度胃食管反流性疾病行腹腔镜胃底折叠术治疗的可行性及安全性。方法:回顾性分析2001年6月至2006年6月对137例中、重度胃食管反流性疾病病人行腹腔镜胃底折叠术的的临床资料。结果:121例行腹腔镜Nissen胃底折叠术,16例作腹腔镜Toupet胃底折叠术。术后症状完全缓解。术后4个月,食管下段压力由7.28±1.32 mmHg提高到19.01±3.39 mmHg(t=11.69,P<0.01)。24 h pH值监测评分由181.76±95.47降低至8.13±1.96(t=8.38,P<0.01),较手术前有明显改善,并达到正常范围。长期随访临床效果良好。无严重手术并发症,无中转开腹及死亡病例。结论:对于严重的胃食管反流性疾病,腹腔镜胃底折叠术是一种微创、安全、有效的治疗方法。Objective To evaluate the feasibility and reliability of laparoscopic fundoplication in the treatment of severe gastroesophageal reflux disease. Methods The clinical data from 137 patients undergoing laparoscopic fundoplication from June 2001 to June 2006 were reviewed. Results Laparoscopic Nissen fundoplication was performed in 121 cases, and laparoscopic Toupet fundoplication in 16 cases. The preoperative symptoms were completely ameliorated. Postoperatively the lower esophageal pressure was elevated from （7.28±1.32） mmHg to （19.01±3.39） mmHg （t=11.69, P〈0.01）. The DeMeester s core of 24 h pH monitoring was significantly declined from 181.76±95.47 to 8.13±1.96 （t=8.38, P〈0.01）. No postoperative complications were observed. There was no conversion to open surgery and no death occurred. Conclusions Laparoscopic fundoplication is a minimally-invasive, safe and effective procedure in the treatment of severe gastroesophageal reflux disease.

关 键 词：胃食管反流 胃折叠术 腹腔镜 方法 

分 类 号：R655.4[医药卫生—外科学]