内镜下射频治疗术在顽固性胃食管反流病患者治疗中的应用价值  

Application Value of Endoscopic Radiofrequency Therapy in the treatment of Patients with Refractory Gastroesophageal Reflux Disease

作　　者：蓝志华 叶志刚 Lan Zhihua;Ye Zhigang(The People's Hospital of Wuhua County,Meizhou Guangdong 514400,China)

机构地区：[1]五华县人民医院,广东梅州514400

出　　处：《医疗装备》2021年第16期8-10,共3页Medical Equipment

基　　金：梅州市科技计划项目(2019B50)。

摘　　要：目的探究内镜下射频治疗术在顽固性胃食管反流病(GERD)患者治疗中的应用价值。方法回顾性分析2018年1月至2020年1月五华县人民医院收治的80例顽固性GERD患者的临床资料,按照治疗方法的不同分为对照组和试验组,各40例。对照组行内镜下抗反流黏膜切除术,试验组行内镜下射频治疗术,术后均进行6个月的随访,比较两组术前及术后6个月的症状评分(反酸、胃灼热)、24 h食管pH监测状况(pH<4时间占比、长反流次数、最长反流时间)及并发症发生率。结果术前,两组症状评分及24 h食管pH监测状况比较,差异无统计学意义(P>0.05);术后6个月,两组反酸、胃灼热症状评分及pH<4时间占比均低于术前,长反流次数均少于术前,最长反流时间均短于术前,且试验组均优于对照组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论相较于内镜下抗反流黏膜切除术,采用内镜下射频治疗术治疗顽固性GERD患者,可更好地改善临床症状及24 h食管pH监测状况,且安全性较高。Objective To explore the application value of endoscopic radiofrequency therapy in the treatment of refractory gastroesophageal reflux disease.Methods Clinical data of 80 patients with refractory GERD admitted to Wuhua County People's Hospital from January 2018 to January 2020 were retrospectively analyzed,according to the different treatment methods,they were divided into control group and experimental group,40 cases in each group.The control group underwent endoscopic anti-reflux mucosal resection,The experimental group underwent endoscopic radiofrequence therapy.All patients were followed up for 6 months after surgery.Symptom scores(acid reflux,heartburn),esophageal pH monitoring at 24 h(pH<4 time ratio,long reflux times,longest reflux time)and complication rates were compared between the two groups before surgery and 6 months after surgery.Results Before surgery,there was no statistical significance in symptom score and 24 h esophageal pH monitoring between the two groups(P>0.05).6 months after surgery,the scores of acid reflux,heartburn symptoms and the proportion of time pH<4 in both groups were lower than before surgery,the frequency of long reflux was less than that before operation,the longest duration of reflux was shorter than that before surgery,the differences were statistically significant(P<0.05).The incidence of complications was compared between the two groups,the difference was not statistically significant(P>0.05).Conclusion Compared with endoscopic anti-reflux mucosal resection,endoscopic radiofrequency therapy can improve the clinical symptoms and 24-hour esophageal Ph monitoring in patients with refractory Gerd.

关 键 词：顽固性胃食管反流病 内镜下射频治疗术 内镜下抗反流黏膜切除术 并发症 

分 类 号：R573[医药卫生—消化系统]