小儿食管裂孔疝外科治疗的疗效  

Outcome of surgical operation on hiatus hernia in children

作　　者：周崙[1] 郑光海[2] 曹一鸣[2] 魏孝钰[2] 郑炜[1] 

机构地区：[1]福建医科大学附属协和医院胸外科,福州350001 [2]福建医科大学附属协和医院小儿外科,福州350001

出　　处：《中华小儿外科杂志》2002年第3期218-219,共2页Chinese Journal of Pediatric Surgery

摘　　要：目的　评价小儿食管裂孔疝外科治疗的疗效。方法　 1981年 3月～ 2 0 0 0年 10月修补裂孔疝 2 1例 ,并做 3种抗反流手术 (重建His角 ,Belsey手术及Nissen手术 ) ;术后根据临床表现、X线钡餐检查、食管测压及 2 4hpH监测 ,评价手术疗效。 结果　无手术死亡。 2例再次修补滑动疝 ,1例并发反流性食管溃疡于术后 9年切除食管下段后行食管胃吻合。术后随访 8～ 14年 9例 ,4～ 5年 2例 ,2～ 3年 6例 ,6～ 10个月 3例及 2个月 1例 ;术前症状均消失 ,体重、身高增加 ;X线钡餐检查 :2 0例贲门位膈下 ,钡剂通过顺畅 ,无胃食管反流 ;2例食管下括约肌有高压带 ,pH总计分基本正常。结论　食管裂孔疝修补术附加 3种抗反流手术 ,疗效均良好 ,如无并发短食管及食管狭窄可经腹修补及重建His角抗反流。Objective To evaluate the outcome of surgical operation on hiatus hernia (HH) in children.Methods Twenty one cases underwent operative repair of HH using 3 antireflux procedures (reconstruction of His angle, Belsey procedure and Nissen's operation). The operative results were evaluated according to symtomatology, Barium meal study, esophageal manometry and 24 h pH monitoring.Results There was no operative death. Nine cases were followed up for 8～14 years, 2 cases for 4～5 years, 6 cases for 2～3 years, 3 cases for 6～10 months and 1 for 2 months. The preoperative symptoms disappeared in all of them. The children have gained weight and height. The gastroesophageal reflux was not observed on Barium meal examination in 20 cases. One patient with lower esophageal stenosis due to reflux esophagitis underwent lower esophagectomy and esophago gastrostomy, pH study was normal.Conclusion The results of operative repair with 3 choices of antireflux procedures are effective in HH.

关 键 词：食管裂孔疝 外科治疗 疗效 手术方式 再手术 儿童 

分 类 号：R726.5[医药卫生—儿科]