食管裂孔疝与膈疝的诊疗异同及对策  

Differences and Similarities in diagnosis and treatment of hiatal hernia and diaphragmatic hernia and surgical strategy

作　　者：杨福全[1] YANG Fu-quan(Department of General Surgery,Colonrectum and Hernia Surgical Ward,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院结直肠、疝、微创外科,辽宁沈阳110004

出　　处：《中国实用外科杂志》2024年第4期428-430,共3页Chinese Journal of Practical Surgery

基　　金：国家科技支撑计划课题(No.2015BAI13B09)。

摘　　要：食管裂孔疝和膈疝均有与疝病相关的临床表现,食管裂孔疝多伴有胃食管反流相关的症状。胸部CT有助于确诊膈疝,食管裂孔疝病人还需要进行胃镜和食管测酸测压检查以明确胃食管反流情况。应根据病人临床症状和辅助检查结果制定相应的治疗方案,手术修补是治疗食管裂孔疝和膈疝的有效方法,对于有胃食管反流症状病人需要同时进行胃底折叠抗反流手术,部分研究证据表明采用补片加强修补有助于降低疝的复发率。Both hiatal hernia and diaphragmatic hernia have similar clinical manifestations related to the hernia disease,and esophageal hiatus hernia is often accompanied by symptoms related to gastroesophageal reflux.Chest CT is helpful for the diagnosis of diaphragmatic hernia.Patients with esophageal hiatal hernia also need gastroscopy and esophageal pressure and PH measurement to determine the gastroesophageal reflux.According to the patient's clinical symptoms and auxiliary examination results,the corresponding treatment plan is formulated.Surgical repair is an effective method to treat hiatal hernia and diaphragmatic hernia.For patients with gastroesophageal reflux symptoms,fundoplication anti-reflux surgery is needed at the same time,and partial research evidence suggest that mash reinforcement repair is helpful to reduce the recurrence rate.

关 键 词：食管裂孔疝 膈疝 胃食管反流病 外科治疗 

分 类 号：R6[医药卫生—外科学]