伏诺拉生联合贲门缩窄术治疗重度反流性食管炎的效果评估  

Evaluation of the Efficacy of Vonoprazan Combined with Cardial Constriction Surgery in the Treatment of Severe Reflux Esophagitis

作　　者：张静智[1] 曾玲[1] 刘雪[1] 叶鹏 石柳[1] 温建军[1] ZHANG Jingzhi;ZENG Ling;LIU Xue;YE Peng;SHI Liu;WEN Jianjun(People's Hospital of Ganzhou City,Jiangxi Province,Ganzhou 341000,China;不详)

机构地区：[1]江西省赣州市人民医院,江西赣州341000

出　　处：《中国医学创新》2023年第21期34-38,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(202212464)。

摘　　要：目的:探讨伏诺拉生联合贲门缩窄术治疗重度反流性食管炎(RE)的临床效果。方法:选取赣州市人民医院2021年6月-2022年8月收治的60例重度RE患者,根据随机数字表法将患者分为对照组(30例)、观察组(30例);对照组采用雷贝拉唑+贲门缩窄术治疗,观察组采用伏诺拉生+贲门缩窄术治疗;对比两组临床症状评分[胃食管反流病问卷(GerdQ)]、食管动力学指标[食管远端收缩积分(DCI)]、上食管括约肌压力(UESP)、卧位反流时间百分比(PRRT)及下食管括约肌压力(LESP)、24 h酸反流、食管黏膜愈合及复发情况。结果:治疗1个月,观察组GerdQ评分较对照组低,差异有统计学意义(P<0.05);治疗1个月,观察组LESP较对照组高,PRRT较对照组低,差异均有统计学意义(P<0.05);两组治疗前、治疗1个月DCI、UESP对比差异均无统计学意义(P>0.05);治疗1个月,观察组反流次数较对照组低,最长反流持续时间均较对照组短,差异均有统计学意义(P<0.05);观察组食管黏膜总愈合率较对照组高,复发率较对照组低,差异均有统计学意义(P<0.05)。结论:重度RE患者采用伏诺拉生联合贲门缩窄术治疗可减轻临床症状,改善食管动力学,减少24 h酸反流情况,促进食管黏膜愈合,降低复发率。Objective:To explore the clinical efficacy of Vonoprazan combined with cardial constriction surgery in the treatment of severe reflux esophagitis(RE).Method:Sixty patients with severe RE admitted to People's Hospital of Ganzhou City from June 2021 to August 2022 were selected and divided into control group(30 cases)and observation group(30 cases)according to random number table.The control group was treated with Rabeprazole+cardial constriction surgery,while the observation group was treated with Vonoprazan+cardial constriction surgery.The clinical symptoms scores(GerdQ),esophageal motility indexes[distal esophageal constriction score(DCI),upper esophageal sphincter pressure(UESP),percentage of recumbent reflux time(PRRT)and lower esophageal sphincter pressure(LESP)],24-hour acid reflux,esophageal mucosal healing and recurrence were compared between the two groups.Result:After one month of treatment,the GerdQ score of the observation group was lower than that of the control group,the difference was statistically significant(P<0.05);after one month of treatment,the LESP of the observation group was higher than that of the control group,and PRRT of the observation group was lower than that of the control group,the differences were statistically significant(P<0.05);there were no statistically significant differences in DCI and UESP between the two groups before and after 1 month of treatment(P>0.05);after one month of treatment,the frequency of reflux in the observation group was lower than that in the control group,and the longest duration of reflux was shorter than that in the control group,with statistically significant differences(P<0.05);the total healing rate of the esophageal mucosa in the observation group was higher than that in the control group,and the recurrence rate was lower than that in the control group,with statistically significant differences(P<0.05).Conclusion:The combination of Vonoprazan and cardial constriction surgery can alleviate clinical symptoms,improve esophageal dynamics,reduce 24-hour

关 键 词：反流性食管炎 伏诺拉生 贲门缩窄术 食管动力学 食管黏膜愈合 

分 类 号：R571[医药卫生—消化系统]