腹腔镜胃底折叠术治疗胃食管反流相关性高血压病临床研究  

Clinical Effect of Surgical Treatment of Gastroesophageal Reflux Disease Related Hypertension

作　　者：季锋[1] 汪忠镐[1,2] 韩新巍[1] 李治仝[1] 王利[1] 陈建华[1] 白林锋 崔强[1] 高翔[2] 张成超 

机构地区：[1]郑州大学第一附属医院介入科,郑州450052 [2]首都医科大学附属宣武医院血管外科研究所,北京100053 [3]航天总医院血管外科,北京100076

出　　处：《临床误诊误治》2015年第7期77-79,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的观察胃食管反流病（gastroesophageal reflux disease,GERD）与高血压病的相关性以及腹腔镜胃底折叠术治疗胃食管反流相关性高血压病的效果。方法回顾性分析2011年6月—2012年6月我院18例行腹腔镜Nissen胃底折叠术的GERD合并高血压病患者的临床资料。结果本组GERD病程（9.4±6.0）年,高血压病病程（5.2±6.0）年;13例以GERD症状首发,1～19年后合并高血压病,5例以高血压首发,0.8～10年后出现GERD症状。均手术成功,未发生气胸、食管破裂等术后严重并发症。本组术后12个月收缩压和舒张压均较术前下降（t=4.095,P=0.001;t=3.014,P=0.001）,高血压病疗效：9例临床治愈,3例有效,6例无效。术后Sc（疗效评价总积分）由术前18.50（14.25）分降至0（2.00）分（z=3.726,P=0.001）,每例Sc均〈12分,临床均治愈。结论 GERD与部分高血压病密切相关,腹腔镜胃底折叠术治疗胃食管反流相关性高血压病安全、有效。Objective To research the association between gastroesophageal reflux disease （GERD） and essential hypertension and the efficiency of laparoscopic Nissen fundoplication in the treatment of GERD-related hypertension. Methods We retrospectively analyzed the clinical data of 18 patients with essential hypertension undergoing laparoscopic fundoplica- tion for GERD between June 2011 and June 2012. Results 18 cases were diagnosed in compliance with GERD and hyperten- sion standard. The duration of GERD was （9.4 ± 6.0） years and the course of hypertension was （5.2 ± 6.0） years. The first symptoms were GERD symptoms in 13 cases and the complication of hypertension was found 1 to 19 years later. The first symptom was hypertension in 5 cases and the occurrence of GERD were from 0.8 to 10 years later, indicating that the GERD was treated successfully. 1 year after the operation, the systolic blood pressure of these patients was decreased （t = 4. 095, P = 0. 001 ） , and the diastolic blood pressure was decreased （t = 3. 014, P = 0. 001 ）. Further more, the hypertension medi- cation was discontinued in 9 patients, the dose was reduced in 3 patients, and the medication was continued in 6 patients. The total score （Sc） decreased from 18.50 （14.25） preoperatively to 0 （2.00） postoperatively （z = 3. 726, P = 0. 001 ）. Con- clusion GERD is closely related to essential hypertension. Therefore, laparoscopic Nissen fundoplication is a safe and effec- tive way of treatment for patients with GERD-related hypertension.

关 键 词：高血压 并发症 胃食管反流 胃底折叠术 血压 

分 类 号：R656.6[医药卫生—外科学] R544.1[医药卫生—临床医学]