腹腔镜胃底折叠术后复发烧心症状与食管内酸反流的关系  

Correlation between recurrent heartburn after laparoscopic fundoplication and intra-esophageal acid reflux

作　　者：蔡旺[1,2,3] 秦鸣放[3] 王庆[3] 勾承月[3] 李宁[3] 

机构地区：[1]天津医科大学研究生院 [2]天津医科大学南开临床学院 [3]天津市南开医院微创外科,天津市300100

出　　处：《世界华人消化杂志》2010年第34期3695-3698,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨腹腔镜胃底折叠术后自称有复发烧心症状的患者24h食管pH监测结果是否异常,是否有特殊的症状和/或其他因素与pH监测异常结果相关.方法:在天津市南开医院接受治疗的胃底折叠术后有"复发烧心感"的患者为研究对象.对入选患者进行胃镜,食管动力学检查及24h食管pH值监测并进行统计学分析.术后定期随访.对烧心症状、饮食吞咽困难症状等进行评分分析.结果:56例患者复查pH监测正常的患者中46例(82%)pH<4的时间为不到1%.三项术后指标与24h食管pH监测的结果有明显的联系,分别为部分胃底折叠术(P=0.039),术后超过6mo的再发症状时间(P<0.001),抑酸药物效果明显(P=0.015).结论:绝大多数腹腔镜胃底折叠术后出现复发烧心症状的患者并没有客观证据证明有胃食管酸反流复发.AIM：To determine whether patients complain-ing of recurrent heartburn after laparoscopic fundoplication have abnormal 24-h esophageal pH monitoring results and if there are any spe-cific symptoms and/or factors could be linked to abnormal postoperative pH study results.METHODS：Patients who complained of recur-rent heartburn after laparoscopic fundoplication were enrolled to undergo endoscopy,manom-etry,and 24-h esophageal pH monitoring.Rou-tine follow-ups were performed and symptoms were scored,recorded and statistically analyzed.RESULTS：Approximately 82%of patients who had normal pH study results had acid exposure（pH4）in less than 1%of the total time.Post-operative pH study results were found be to be significantly associated with the following three fac-tors：partial fundoplication（P=0.039,P0.001,P= 0.015）,onset of recurrent symptoms after surgery,and control effects of preoperative antacid therapy.CONCLUSION：There is no objective evidence demonstrating the development of recurrent acid reflux in the majority of patients complain-ing of recurrent heartburn after laparoscopic fundoplication.

关 键 词：腹腔镜胃底折叠术 胃食管反流疾病 复发烧心症状 24H食管PH监测 

分 类 号：R571[医药卫生—消化系统]