袖状胃切除术对代谢综合征患者胃食管反流症状的影响  

Effect of sleeve gastrectomy on gastroesophageal reflux in patients with metabolic syndrome

作　　者：孙林丽[1] 苏志红[1] 李鹏洲[1] 李伟正[1] 朱晒红[1] 朱利勇[1] SUN Linli;SU Zhihong;LI Pengzhou;LI Weizheng;ZHU Shaihong;ZHU Liyong(Department of Bariatric and Metabolic Surgery,Third Xiangya Hospital,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院减重代谢外科,长沙410013

出　　处：《中南大学学报（医学版）》2020年第3期328-333,共6页Journal of Central South University ：Medical Science

基　　金：湖南省自然科学基金(2019JJ50921)。

摘　　要：目的:探讨代谢综合征患者接受袖状胃切除术后胃食管反流病的发生率及袖状胃切除术对胃食管反流症状的影响。方法:回顾性分析2018年4月至2019年5月在中南大学湘雅三医院减重代谢外科接受腹腔镜下袖状胃切除术治疗的60例(男31名,女29名)减重代谢患者手术前后胃食管反流症状,并评估术前术后症状的变化情况。结果:患者年龄16~46(29.17±7.23)岁;术前体重为(116.02±31.96) kg,术后1个月为(98.32±25.22) kg;术前BMI为(39.67±8.90) kg/m^2,术后1个月为(34.4±7.85) kg/m^2。术前胃食管反流发病人数为37(61.67%),术后1个月为18(30.00%)。术前无症状而术后1个月出现明显胃食管反流症状的人数为4(6.67%)。在37例术前有胃食管反流的患者中,术后胃食管反流症状持续存在或加重的人数为6(16.62%),而术后1个月无胃食管反流的人数为23(62.16%),术后1个月胃食管反流好转的人数为8(21.62%)。治疗后胃食管反流病-健康相关生活质量量表部分项目评分(如饭后反流)较治疗前明显降低,差异具有统计学意义(P<0.05)。结论:代谢综合征患者袖状胃切除术后胃食管反流症状得到有效改善,袖状胃切除术对肥胖合并胃食管反流病是可行、安全、有效的治疗方式。Objective: To investigate the incidence of gastroesophageal reflux disease(GERD) after sleeve gastrectomy and the effect of sleeve gastrectomy in treating the symptom of gastroesophageal reflux in patients with metabolic syndrome.Methods: We retrospectively analyzed 60 patients with metabolic syndrome who received laparoscopy sleeve gastrectomy in the Department of Bariatric and Metabolic Surgery,Third Xiangya Hospital of Central South University from April 2018 to May 2019, and assessed the changes of symptoms before and after surgery.Results: The study included 31 men and 29 women. The age of these patients was 16-46(29.17±7.23) years, ranging from 16 to 46 years. The weight and body mass index(BMI)of the patients decreased from(116.02±31.96) kg and(39.67±8.90) kg/m^2 to(98.32±25.22) kg and(34.4±7.85) kg/m^2 at 1 month after the surgery, respectively. The number of patients with gastroesophageal reflux was 37(61.67%) before the surgery, and 18(30.00%) at 1 month after the surgery, respectively. The number of asymptomatic patients before the surgery while had gastroesophageal reflux symptoms within 1 month after the surgery was4(6.67%). Among the 37 patients, 6(16.62%) had persisted or worsen symptoms with gastroesophageal reflux symptoms before the surgery, 23(62.16%) had no symptoms, and 8 patients(21.62%) showed improvement of gastroesophageal reflux 1 month after the surgery. Some scores of the GERD-Health-Related Quality of Life Scale(such as reflux after dinner) were significantly lower after the surgury than those before the surgery(P<0.05).Conclusion: The symptoms of GERD are effectively improved after surgery. Sleeve gastrectomy is a feasible, safe and effective treatment for obesity with GERD.

关 键 词：代谢综合征 袖状胃切除术 胃食管反流 疗效 

分 类 号：R656.61[医药卫生—外科学]