Gastroesophageal reflux disease:recent innovations in endoscopic assessment and treatment  

胃食管反流病:内镜评估与治疗方面的革新

作　　者：Sheng Chen Feng Du Changqing Zhong Caifang Liu Xiaoying Wang Yan Chen Gang Wang Xiaopei Gao Lu Zhang Lianyong Li Wei Wu 

机构地区：[1]Department of Gastroenterology,PLA Strategic Support Force Characteristic Medical Center,Beijing,P.R.China [2]State Environmental Protection Key Laboratory of Environmental Sense Organ Stress and Health,PLA Strategic Support Force Characteristic Medical Center,Beijing,P.R.China [3]Department of Internal Medicine,The Hospital of the People’s Liberation Army 63650 Corps,Malan,Xinjiang,P.R.China [4]Department of Pediatrics,The First Affiliated Hospital of Xi’an Medical University,Xi’an,Shaanxi,P.R.China [5]Department of Otorhinolaryngology Head and Neck Surgery,PLA Strategic Support Force Characteristic Medical Center,Beijing,P.R.China

出　　处：《Gastroenterology Report》2021年第5期383-391,I0001,共10页胃肠病学报道（英文）

摘　　要：Innovations in endoscopy have brought about some impressive improvements in diagnosing and treating gastroesophageal reflux disease(GERD).GERD,as one of the most prevalent gastrointestinal disorders in the world,has always been on the cutting edge of endoscopic interventions.A primary diagnosis of GERD is based on symptoms and an initial trial of proton-pump inhibitor(PPI)therapy,which is devoid of adequately instructive value for therapeutic strategies.Endoscopy and optional biopsies can be used to directly observe and determine the abnormal structural and pathophysiological damage in the esophagus.The emergence of minimally invasive endoscopic therapyfills the gap between patients who are reluctant or insensitive to PPIs and candidates who are not indicated for surgical anti-reflux fundoplication.In this review,we discuss the utility of endoscopy and biopsy in patients with persistent GERD-related manifestations after proper medical anti-reflux treatment.Moreover,we portray a landscape of four current endoscopic GERD therapies and clarify the merits and disadvantages of each technique.Future research needs to concentrate on stratifying GERD patients based on personal conditions and elucidating the primary pathophysiology of GERD.内镜技术的创新为胃食管反流病(GERD)的诊治带来了巨大进步。作为世界上最常见的胃肠疾病之一,GERD一直是内镜介入治疗的前沿。目前,GERD的初步诊断是基于症状和质子泵抑制剂(PPI)初期治疗有效,但这对治疗策略的指导价值有限。然而,内镜检查和病理活检可直接观察和判断食管的异常结构和病理生理损伤;同时,内镜治疗的出现给PPI治疗依从性较差或治疗反应不佳以及不适合行胃底折叠抗反流手术的患者提供了新的治疗选择。本综述对内镜检查和活检在经过恰当的抗反流药物治疗后持续存在GERD相关临床表现的患者中的应用情况进行了概述,并介绍了目前内镜治疗GERD的各项新技术及其优缺点。今后的研究需要对GERD患者进行分层研究,并力图阐明该疾病的主要病理生理机制。

关 键 词：gastroesophageal reflux disease ENDOSCOPY BIOPSY treatment 

分 类 号：R57[医药卫生—消化系统]