内镜下抗反流黏膜切除术治疗难治性胃食管反流病的效果及安全性分析  

Effect and safety analysis of endoscopic anti-reflux mucosal resection for refractory gastroesophageal reflux disease

作　　者：谢本江 李学志 徐晓菲 XIE Ben-jiang;LI Xue-zhi;XU Xiao-fei(Department of Gastroenterology,Dianbai District People’s Hospital,Maoming 525400,China)

机构地区：[1]电白区人民医院消化内科,525400

出　　处：《中国实用医药》2021年第11期17-19,共3页China Practical Medicine

摘　　要：目的分析内镜下抗反流黏膜切除术治疗难治性胃食管反流病的效果及安全性。方法70例难治性胃食管反流病患者,全部接受内镜下抗反流黏膜切除术治疗,分析患者的手术情况、并发症发生情况,并比较手术前后的反流症状评分、胃功能指标、生活质量评分。结果70例患者全部顺利完成手术,术中、术后均未发生严重并发症,患者整体恢复情况良好;患者术后1、3、6个月反流症状评分分别为(10.23±1.75)、(6.14±1.01)、(2.45±0.89)分,均低于术前的(17.95±3.54)分,差异有统计学意义(P<0.05)。患者术后胃动素(345.78±86.15)ng/L、胃泌素(178.88±22.21)pg/ml均高于术前的(240.35±72.98)ng/L、(107.57±14.55)pg/ml,差异有统计学意义(P<0.05)。70例患者术后躯体功能评分(80.55±2.37)分、心理功能评分(80.35±2.32)分、社会功能评分(80.24±2.31)分、物质生活状态评分(80.31±2.28)分均高于术前的(74.36±2.25)、(74.28±2.12)、(74.19±2.26)、(74.22±2.11)分,差异有统计学意义(P<0.05)。70例患者在手术期间未发生任何并发症,2例患者术后出现轻微感染,经对症处理,感染消失,未对术后恢复造成较大影响。结论在难治性胃食管反流病患者临床治疗中应用内镜下抗反流黏膜切除术,可良好改善患者反流症状、胃功能指标以及生活质量,且不会造成过多严重并发症,治疗效果、安全性理想可靠。Objective To analyze the effect and safety of endoscopic anti-reflux mucosal resection for refractory gastroesophageal reflux disease.Methods 70 patients with refractory gastroesophageal reflux disease all received endoscopic anti-reflux mucosal resection.The surgical status,occurrence of complications were analyzed,and the reflux symptom score,gastric function indicators and quality of life score before and after surgery were compared.Results All 70 patients complete the surgery successfully,no serious complications during and after the surgery,and the overall recovery was good.The reflux symptom score 1,3 and 6 months after surgery were(10.23±1.75),(6.14±1.01)and(2.45±0.89)points,which were all lower than(17.95±3.54)points before surgery,and the difference was statistically significant(P<0.05).After surgery,the motilin(345.78±86.15)ng/L and gastrin(178.88±22.21)pg/ml were higher than(240.35±72.98)ng/L and(107.57±14.55)pg/ml before surgery,and the difference was statistically significant(P<0.05).After surgery,the physical function score(80.55±2.37)points,psychological function score(80.35±2.32)points,social function score(80.24±2.31)points and material life state score(80.31±2.28)points of 70 patients were higher than(74.36±2.25),(74.28±2.12),(74.19±2.26)and(74.22±2.11)points before surgery,and the difference was statistically significant(P<0.05).70 patients did not develop any complications during the surgery,and 2 patients developed minor infections after the surgery.After symptomatic treatment,the infection disappeared without major impact on the postoperative recovery.Conclusion The application of endoscopic anti-reflux mucosal resection in the clinical treatment of patients with refractory gastroesophageal reflux disease can well improve the reflux symptoms,gastric function indicators and quality of life of patients without causing too many serious complications,The treatment effect,safety and reliability are ideal and reliable.

关 键 词：难治性胃食管反流病 内镜下抗反流黏膜切除术 临床效果 安全性 

分 类 号：R655.4[医药卫生—外科学]