胃经口内镜下肌切开术干预近端胃切除术后胃食管反流病临床疗效分析  

Clinical analysis of G-POEM intervention for gastroesophageal reflux disease after proximal gastrectomy

作　　者：吴正奇 张志镒 范志宁[2] 卢林芝 李世华 赵光源 张文鸿 秦天燕 WU Zheng-qi;ZHANG Zhi-yi;FAN Zhi-ning;LU Lin-zhi;LI Shi-hua;ZHAO Guan-yuan;ZHANG Wen-hong;QIN Tian-yan(Department of Digestive,Wuwei Cancer Hospital,Wuwei 733000,Gansu,China;Endoscopy Center,Jiangsu Provincial People′s Hospital,Nanjing 210029,Jiangsu,China)

机构地区：[1]甘肃省武威肿瘤医院消化科,武威733000 [2]江苏省人民医院内镜中心,南京210029

出　　处：《东南国防医药》2021年第3期253-256,共4页Military Medical Journal of Southeast China

基　　金：国家重点研发计划(2017YFC0908302)。

摘　　要：目的通过对胃经口内镜下肌切开术(G-POEM)术程的详细描述和分析研究,探讨G-POEM干预近端胃切除术后胃食管反流病的疗效和价值。方法回顾性分析2018年5月-2019年12月在甘肃省武威肿瘤医院接受G-POEM手术治疗的25例近端胃切除术后胃食管反流患者的临床资料,收集术前及术后临床症状、Gerd Q量表评分、手术并发症、术后短期临床效果等数据资料,评估手术治疗后的疗效及安全性。结果25例患者均顺利完成G-POEM手术治疗,术后随访,患者病情均显著改善,反流症状控制良好,术前与术后不同时间段的Gerd Q量表评分差异有统计学意义(F=72.201,P<0.05),Gerd Q评分及胃镜检查提示治疗有效,患者在术后1年内无并发症出现。结论G-POEM是一种安全可行、创伤小且有效的治疗近端胃切除术后引起的胃食管反流病的手术,在未来更多的临床研究中有望进一步评估该手术的安全性和疗效等。Objective To discuss the efficacy and clinical value of G-poem in patients with postoperative gastroesophageal reflux disease after proximal gastrectomy through a detailed description and analysis of the procedure of gastric per-oral endoscopic myotomy(G-POEM).Methods The clinical data of 25 patients with gastroesophageal reflux after proximal gastrectomy who underwent G-POEM surgery at Wuwei Cancer Hospital in Gansu Province from May 2018 to December 2019 were retrospectively analyzed,and their preoperative and postoperative data were collected.Clinical symptoms,Gerd Q score,surgical complications,short-term postoperative clinical results and other data are used to evaluate the efficacy and safety of surgical treatment.Results All 25 patients successfully completed the G-POEM surgical treatment.Follow-up after the operation showed that the patient's condition was significantly improved,and the reflux symptoms were well controlled.There was a statistically significant difference in the Gerd Q scale scores between preoperative and postoperative periods(F=72.201,P<0.05),Gerd Q score and gastroscopy showed that the treatment was effective,and the patient had no complications within a year after surgery.Conclusion G-poem is a feasible and effective method for postoperative gastroesophageal reflux disease after proximal gastrectomy.It is anticipated that the safety and efficacy of this operation will be further evaluated in more clinical studies in the future.

关 键 词：胃经口内镜下肌切开术 近端胃切除术 胃瘫 胃食管反流病 Gerd Q量表 

分 类 号：R655.4[医药卫生—外科学]