胃食管反流病微量射频治疗1年和5年疗效随访研究  

Follow up 1 year and 5 years for radiofrequency treatment of GERD

作　　者：刘建军[1] 汪忠镐[1] 田书瑞[1] 吴继敏[1] 王利营[1] 宋庆[1] 闫军红[1] 张根苗[1] 孙潮涌[1] 

机构地区：[1]第二炮兵总医院胃食管反流病中心,北京100088

出　　处：《疑难病杂志》2013年第9期676-678,I0001,共4页Chinese Journal of Difficult and Complicated Cases

基　　金：国家高技术研究发展计划(863计划)资助项目(No.2007AA02Z4Z6)

摘　　要：目的观察微量射频治疗胃食管反流病食管贲门后1年和5年的疗效。方法对服用抑酸药物无效或不愿服药的胃食管反流病患者,及部分食管外症状未服抑酸药物患者共计138例,行食管贲门微量射频治疗。术后1年、5年随访观察疗效。结果 138例患者5年内总有效110例(79.71%),其中术后5年仍有效91例(65.94%),疗效维持3个月～4年19例(13.77%);无效28例(20.29%)。术后1年及5年时症状明显减轻(P<0.05)。91例5年有效患者中,2～12个月逐渐停药28例(30.77%);需药物维持63例(69.23%),但药量减少。术后复查食管24 h pH监测DeMeester积分降低(P<0.05);下食管括约肌压力(LESP)增高(P<0.05);胃镜下贲门口明显缩紧。射频治疗过程中少量出血,无黏膜撕裂、穿孔、食管狭窄、吞咽困难等并发症。结论内镜下食管微量射频治疗起效快,近远期疗效确切,是治疗难治性及伴食管外症状胃食管反流病的有效方法。Objective To observe radiofrequency effect for gastro-esophageal reflux disease（GERD） after treatment for 1 year and 5 years.Methods GERD patients with acid suppressive medications ineffective or reluctance to take medication, and part of extra-esophageal symptoms patients without taking anti-secretory drugs,underwent radiofrequency treatment. After 1 year and 5 years follow up of efficacy were observed and recorded.Results Of 138 patients,110 cases（79.71%） keep effective during 5 years,after 1 year and 5 year symptoms alleviate（P 0.05）;28 patients（30.77%） gradually discontinued medication in 2 to 12 months;63 patients（69.23%） required to maintain the drug,but the dose were reduced. Post-operation examined 24 hour pH monitoring showed DeMeester score decreased（P 0.05）;lower esophageal sphincter pressure（LESP） increased（P 0.05）,endoscopic mucosal changes have no statistical difference（P 0.05）.Radiofrequency treatment process had a small amount of bleeding,no mucosal tear,perforation,stenosis of esophagus,dysphagia. Conclusion Radiofrequency for GERD onset fast of action,short and long term efficiency is exact;it is an effective endoscopic therapy for refractory and with extra-esophageal symptoms of GERD.

关 键 词：胃食管反流病 难治性 食管外症状 射频治疗 疗效 

分 类 号：R571[医药卫生—消化系统]