消化内镜手术构建食管抗返流屏障治疗犬胃食管返流病效果观察  

Effect of esophageal anti-reflux barrier by digestive endoscopic surgery in treatment of gastroesophageal reflux disease in dogs

作　　者：孙贤久[1] 秦先锋[1] 郭少卿[1] 刘思纯[1] 左海军[1] 张莉[1] 

机构地区：[1]中山大学附属东华医院消化科,广东东莞523110

出　　处：《海南医学》2017年第5期693-695,共3页Hainan Medical Journal

基　　金：广东省2013年度科技计划项目(编号:2013B021800032)

摘　　要：目的研究消化内镜手术构建食管抗返流屏障治疗犬胃食管返流病的效果。方法本研究起止时间为2015年1月至2016年7月,于东华医院消化科应用消化内镜"隧道式"方法剥离食管黏膜并切断食管下段环状肌,制造犬胃食管返流病模型共30只,根据随机数字表法均分为内镜治疗组和药物治疗组,每组15只。内镜治疗组应用消化内镜在胃腔内胃食管交界处手术构建抗返流瓣,药物治疗组应用质子泵抑制剂服药治疗,比较内镜手术治疗和药物治疗对犬胃食管返流病的治疗效果。结果内镜治疗组括约肌长度为(2.63±0.43)cm、食管下段括约肌压力为(2.26±0.30)k Pa、松弛率为(30.47±6.11)%,明显高于药物治疗组的(1.89±0.42)cm、(1.93±0.38)k Pa、(24.75±3.85)%,内镜治疗组的p H<4总时间为(1.03±0.33)h、p H<4监测返流次数(18.46±4.20)次、p H<4返流持续时间>5 min的次数为(2.47±1.36)次,均低于药物治疗组的(1.59±0.42)h、(25.69±3.20)次、(24.75±3.85)次,上述各项指标比较差异均具有统计学意义(P<0.05);内镜治疗组钡剂返流率为6.67%,钡剂清除率为0,均小于药物治疗组的20%和20%,差异均有统计学意义(P<0.05)。结论应用消化内镜手术构建食管抗返流屏障治疗犬胃食管返流病疗效显著,可以为临床胃食管返流病的治疗提供借鉴。Objective To study the effect of esophageal anti-reflux barrier by endoscopic surgery in treatment of gastroesophageal reflux disease（GERD） in dogs. Methods A total of 30 dog models with GERD which applied digestive endoscopy ＂tunnel＂ method of peeling to remove the esophageal mucosa and cut off the esophageal circular muscle in Department of Gastroenterology in Donghua Hospital from January 2015 to July 2016 were established. They were divided into two groups： endoscopic treatment group and drug treatment group, according to the random number table, with 15 dogs in each group. Endoscopic treatment group applied digestive endoscopy in gastric cavity gastroesophageal junction surgery to construct anti-reflux valve, and the drug group was treated with proton pump inhibitor medication. The treatment effect of endoscopic surgical treatment and drug treatment on GERD in dogs was compared.Results The length of the sphincter, lower esophageal sphincter pressure, relaxation rate were respectively（2.63 ±0.43） cm,（2.26±0.30） k Pa,（30.47±6.11）% in endoscopic treatment group, which were significantly higher than those in drug treatment group of（1.89±0.42） cm,（1.93±0.38） k Pa,（24.75±3.85）%. The total time of p H4, monitor reflux number of p H4, reflux duration 〉5 minutes of p〈H4 were respectively（1.03±0.33） h,（18.46±4.20） beats,（2.47±1.36） beats in endoscopic treatment group, which were significantly lower than those in drug treatment group of（1.59 ± 0.42） h,（25.69±3.20） beats,（24.75± 3.85） beats（P〈0.05）. The barium regurgitation rate（6.67%） and barium clearance rate（0） in endoscopic treatment group were less than those in the drug group（20% and 20%）, P〈0.05. Conclusion Construction of esophageal anti-reflux barrier by endoscopic surgery has significant effect in treatment of gastroesophageal reflux disease in dogs, which can provide reference for clinical treatment of GERD.

关 键 词：胃食管返流病 消化内镜手术 抗返流瓣 疗效 

分 类 号：R-332[医药卫生]