内镜下抗反流黏膜切除术治疗难治性胃食管反流病初探  

Preliminary results of anti-reflux mucosectomy in treatment of refractory gastroesophageal reflux disease

作　　者：孙萍胡[1] 王维红[1] 包震飞 丁小云[1] Ping-hu Sun;Wei-hong Wang;Zhen-fei Bao;Xiao-yun Ding(Department of Gastroenterology,the First Hospital,Ningbo,Zhejiang 315000,China)

机构地区：[1]宁波市第一医院消化内科,浙江宁波315000

出　　处：《中国内镜杂志》2020年第7期20-24,共5页China Journal of Endoscopy

摘　　要：目的探讨内镜下抗反流黏膜切除术(ARMS)治疗难治性胃食管反流病(RGERD)的初步疗效及安全性。方法回顾性分析2017年6月-2019年1月宁波市第一医院6例行ARMS治疗的RGERD患者的临床资料,治疗前后行反流症状指数(RSI)、胃食管反流病健康相关生存质量量表(GERD-HRQL)及吞咽困难评分,评价治疗的疗效。结果全组6例患者均顺利完成内镜下ARMS术,无术中术后穿孔、出血等严重并发症。术后随访至少6个月,最长至26个月。术后1个月RSI评分及GERD-HRQL评分为(9.7±3.9)和(11.3±2.3)分,与术前比较,差异均有统计学意义(P<0.01);术后6个月RSI评分及GERD-HRQL评分为(2.8±1.5)和(3.2±1.9)分,与术前比较,差异均有统计学意义(P<0.01)。术后1个月吞咽困难症状改善尚不明显(P>0.05),术后6个月无1例患者存在吞咽困难[评分为(0.0±0.0)分],与术前比较,差异有统计学意义(P<0.05)。结论内镜下ARMS术治疗RGERD的短期疗效好,安全性高。Objective To evaluate the safety and efficacy of endoscopic anti-reflux mucosectomy(ARMS)for refractory gastroesophageal reflux disease.Methods 6 patients who underwent anti-reflux mucosectomy from June 2017 to January 2019 were enrolled in this study,and the clinical data were analyzed retrospectively.RSI,GERDHRQL and dysphagia scores were used before and after the operation for evaluation of curative effect of anti-reflux mucosectomy.Results 6 patients underwent anti-reflux mucosectomy successfully.No major adverse events such as perforation or bleeding was found in perioperative period.The patients were followed up for at least 6 months,and the longest follow-up time was up to 26 months.RSI and GERD-HRQL scores were(9.7±3.9)and(11.3±2.3)respectively one month after ARMS(P<0.01),there was statistical significance between preoperative and one month after ARMS.RSI and GERD-HRQL scores were(2.8±1.5)and(3.2±1.9)respectively 6 months after ARMS(P<0.01),there was also statistical significance between preoperative and 6 months after ARMS.The symptom of dysphagia had not improved one month after ARMS(P>0.05),but no patients felt dysphagia 6 months after ARMS[The score is(0.0±0.0),P<0.05].Conclusion Anti-reflux mucosectomy is efficient and safe to relieve the symptom of refractory gastroesophageal reflux disease in short term.

关 键 词：难治性胃食管反流病(RGERD) 抗反流黏膜切除术 内镜下黏膜剥离术 内镜治疗 安全性 

分 类 号：R57[医药卫生—消化系统]