不同食管下括约肌静息压力的胃食管反流病患者内镜射频治疗的疗效分析  

Efficacy of endoscopic radiofrequency therapy in GERD patients with different resting pressure of lower esophageal sphincter

作　　者：魏雪 卢迪[1] 钱洁 尚占民[1] 郝建宇[1] 高岩[1] Wei Xue;Lu Di;Qian Jie;Shang Zhanmin;Hao Jianyu;Gao Yan(Department of Gastroenterology,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院消化内科,北京100020

出　　处：《中国医刊》2023年第3期262-265,共4页Chinese Journal of Medicine

基　　金：北京市科技计划首都临床特色应用研究与成果推广(Z171100001017054)。

摘　　要：目的对比食管下括约肌(lower esophageal sphincter,LES)静息压力降低与正常的胃食管反流病(gastroesophageal reflux disease,GERD)患者行内镜射频治疗的疗效。方法选取2017年2月至2022年5月于首都医科大学附属北京朝阳医院接受内镜射频治疗的27例GERD患者为研究对象,根据LES静息压力分为压力降低组(14例)和压力正常组(13例)。收集两组患者射频治疗前及治疗后3个月和6个月时的胃食管反流病问卷量表(gastroesophageal reflux disease questionnaire,GerdQ)评分和质子泵抑制剂(proton pump inhibitors,PPI)使用情况等并进行比较。结果射频治疗后3个月及6个月,压力降低组与压力正常组患者的GerdQ评分均较射频治疗前有显著降低(P<0.05),但两组之间比较差异无显著性(P>0.05)。射频治疗后3个月,两组均有超过85%的患者可减少PPI用量。射频治疗后各时间段,两组患者均无严重并发症发生。结论GERD患者无论LES静息压力是否降低,内镜射频治疗均可改善其GerdQ评分,减少PPI用量,且安全性较好。Objective Compare the efficacy of lower esophageal sphincter(LES)reduction versus endoscopic RF therapy in gastroesophageal reflux disease(GERD)patients with normal LES resting pressure.Method 27 GERD patients receiving endoscopic radiofrequency therapy in Beijing Chao-yang Hospital from February 2017 to May 2022 were selected.According to the LES resting pressure of the patients,they were divided into reduced LES resting pressure group and normal LES resting pressure group.Indicators such as the gastroesophageal reflux disease questionnaire(gastroesophageal reflux disease questionnaire,GerdQ)score and the use of proton pump inhibitors(PPI)were collected before and at 3,6 months after radiofrequency therapy.The efficacy of endoscopic radiofrequency therapy was evaluated by comparing the indexes before and after endoscopic radiofrequency therapy in each group of patients.The efficacy of endoscopic radiofrequency therapy in patients with different LES resting pressure was analyzed by comparing the indexes of the two groups before and after radiofrequency therapy.Result At 3,6 months after radiofrequency therapy,the GerdQ score of patients in the reduced LESP group and in the normal LESP group decreased.Both groups showed significant improvement(P<0.05),but there was no significant difference between the two groups.At 3 months after radiofrequency therapy,more than 85%of patients in both groups were able to reduce their PPI usage.No serious complications occurred in this study.Conclusion Endoscopic radiofrequency therapy can improve GerdQ score and reduce PPI dosage,with good safety.

关 键 词：胃食管反流病 食管下括约肌 内镜治疗 射频治疗 

分 类 号：R573[医药卫生—消化系统]