腹腔镜Nissen胃底折叠术联合高选择性迷走神经切断术与传统腹腔镜Nissen胃底折叠术治疗胃食管返流病的临床疗效比较  

Comparison of clinical effects between laparoscopic Nissen fundoplication combined with highly selective vagotomy and traditional laparoscopic Nissen fundoplication in treatment of gastroesophageal reflux disease

作　　者：张宏[1] 鲁鹤臻 李志宏[1] 王凯忠[1] 任平[1] 付彤[3] 

机构地区：[1]吉林大学第一医院胸外科,吉林长春130021 [2]吉林大学临床医学院 [3]吉林大学第一医院乳腺外科,吉林长春130021

出　　处：《吉林大学学报（医学版）》2014年第6期1280-1284,共5页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科研基金资助课题(20100740;201015155)

摘　　要：目的:比较腹腔镜Nissen胃底折叠术(LNF)联合高选择性迷走神经切断术(HSV)(LNFHSV)与传统LNF治疗胃食管反流病(GERD)的临床效果,为LNFHSV的临床应用提供参考。方法:选择实施LNFHSV的GERD 22例患者的临床资料,以同期实施LNF的36例GERD患者作为对照,比较2组患者的平均手术时间、术中平均出血量、平均住院时间、术后恢复进食时间和术后主要并发症发生率、烧心严重程度评分和术后Demeester评分等临床指标。结果:2组患者术中平均出血量、平均住院时间、术后恢复进食时间和术后主要并发症发生率比较差异无统计学意义(P>0.05);LNFHSV组患者手术时间明显长于LNF组(P<0.05);LNFHSV组患者术后烧心严重程度评分和Demeester评分明显优于LNF组(P<0.05)。结论:LNFHSV是治疗GERD,尤其是伴有高胃酸分泌的GERD患者的有效手术方式,其治疗效果优于LNF。Objective To compare the clinical effects of laparoscopic Nissen fundoplication （LNF）combined with highly selective vagotomy（HSV）（LNFHSV）in treatment of gastroesophageal reflux disease（GERD）,and to provide reference for the clinical application of LNFHSV.Methods 22 patients with a history of GERD unrelieved by medication and underwent LNFHSV were selected.At the same time ,36 patients with GERD underwent LNF were used as control.The mean operation time,hospital stay,incidence of main operative complications,HSS complete remission and Demeester scores of the patients in two groups were retrospectively analyzed.Results The Demeester scores,hospital stay, incidence of main operative complications of the patients in two groups before operation had no significant differences（P〉0.05）.The mean operation time in LNFHSV group （90 min±35 min） was longer than that in LNF group（65 min± 21 min）.The Demeester scores of the patients in two groups after operation had significant difference（P〈0.05）.The HSS complete remission rate of the patients in LNFHSV group was 91.1%,the part remission rate was 8.9%,and no effectiveness was 0;they were 83.3%,13.8%,and＆amp;nbsp;2.8% in LNF group;there were significant differences between two groups（P〈0.05）.Conclusion LNFHSV has better effectiveness in controlling GERD than LNF procedure.

关 键 词：腹腔镜胃底折叠术 胃食管返流性疾病 高选择迷走神经切断术 

分 类 号：R655[医药卫生—外科学]