经口内镜下贲门缩窄术治疗难治性胃食管反流病的临床效果  

Clinical effect of transoral endoscopic cardiac constriction in the treatment of refractory gastroesophageal reflux disease

作　　者：李红刚 何晓锐 王淑红 LI Honggang;HE Xiaorui;WANG Shuhong(Xi'an Fengcheng Hospital,Xi'an 710021;Xi'an Daxing Hospital,Xi'an 710000,China)

机构地区：[1]西安凤城医院,陕西西安710021 [2]西安大兴医院,陕西西安710000

出　　处：《临床医学研究与实践》2022年第18期54-57,65,共5页Clinical Research and Practice

摘　　要：目的探讨经口内镜下贲门缩窄术治疗难治性胃食管反流病(RGERD)的临床效果。方法选取2019年12月至2021年11月我院收治的48例RGERD患者为研究对象,按照随机数字表法将其分为对照组与观察组,每组24例。对照组采用艾司奥美拉唑镁肠溶片联合枸橼酸莫沙必利片进行治疗,观察组采用经口内镜下贲门缩窄术治疗。比较两组的治疗效果。结果观察组的治疗总有效率为95.83%,明显高于对照组的66.67%,差异具有统计学意义(P<0.05)。治疗后2个月,观察组的反流总次数、酸反流次数、弱酸反流次数、非酸性反流次数均明显少于治疗前和对照组,酸反流时间及最长反流时间均明显短于治疗前和对照组(P<0.05)。治疗后2个月,两组患者的液体反流、气体反流、液气混合反流发生频率均较治疗前明显降低,且观察组低于对照组(P<0.05)。治疗后2个月,两组的病理性食管酸暴露率及近端反流率均较治疗前明显降低,且观察组低于对照组(P<0.05)。治疗后2个月,两组的反流性疾病问卷(RDQ)、反流症状指数评分量表(RSI)及胃食管反流病健康相关生活质量量表(GERD-HRQL)评分均较治疗前明显降低,且观察组低于对照组(P<0.05)。观察组的满意度为100.0%,明显高于对照组的75.00%(P<0.05)。结论经口内镜下贲门缩窄术治疗RGERD的效果显著,可改善反流症状,降低病理性食管酸暴露率及近端反流率,提高患者的生活质量及满意度。Objective To investigate the clinical effect of transoral endoscopic cardiac constriction in the treatment of refractory gastroesophageal reflux disease(RGERD).Methods Forty-eight patients with RGERD treated in our hospital from December 2019 to November 2021 were selected as the research objects.The patients were divided into control group and observation group according to random number table method,with 24 cases in each group.The control group was treated with esomeprazole magnesium enteric-coated tablets combined with mosapride citrate tablets,and the observation group was treated with transoral endoscopic cardiac constriction.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was 95.83%,which was significantly higher than 66.67%in the control group,and the difference was statistically significant(P<0.05).Two months after treatment,the total reflux times,acid reflux times,weak acid reflux times and non-acid reflux times in the observation group were significantly less than those before treatment and in the control group,and the acid reflux time and the longest reflux time in the observation group were significantly shorter than those before treatment and in the control group(P<0.05).Two months after treatment,the occurrence frequencies of liquid reflux,gas reflux and liquid gas mixed reflux in the two groups were significantly lower than those before treatment,and those in the observation group were lower than the control group(P<0.05).Two months after treatment,the pathological esophageal acid exposure rate and proximal reflux rate of the two groups were significantly lower than those before treatment,and those in the observation group were lower than the control group(P<0.05).Two months after treatment,the scores of reffux diagnostic questionnaire(RDQ),reflux symptom index(RSI),health related quality of life scale for gastroesophageal reflux disease(GERD-HRQL)in the two groups were significantly lower than those before treatment,and

关 键 词：经口内镜下贲门缩窄术 难治性胃食管反流病 病理性食管酸暴露率 

分 类 号：R655.4[医药卫生—外科学]