内镜下贲门缩窄术联合艾司奥美拉唑治疗反流性食管炎合并食管裂孔疝的临床观察  

Clinical observation of endoscopic cardial constriction combined with esomeprazole in the treatment of reflux esophagitis complicated by hiatal hernias

作　　者：陈芳洁[1] 刘月圆 辛小敏 Chen Fangjie;Liu Yueyuan;Xin Xiaomin(Department of Gastroenterology,Anyang People’s Hospital,Anyang 455000,China)

机构地区：[1]安阳市人民医院消化内科,安阳455000

出　　处：《中国实用医刊》2024年第18期17-20,共4页Chinese Journal of Practical Medicine

摘　　要：目的分析内镜下贲门缩窄术联合艾司奥美拉唑用于反流性食管炎合并食管裂孔疝的临床效果。方法队列研究。抽取2021年3月至2023年3月安阳市人民医院收治的反流性食管炎合并食管裂孔疝患者146例,按随机数字表法分为对照组和观察组,每组73例。对照组采用艾司奥美拉唑、铝碳酸镁、枸橼酸莫沙必利治疗,观察组采用内镜下贲门缩窄术联合艾司奥美拉唑治疗。比较两组反流次数、反流时间、反流发生频率、反流性疾病问卷(RDQ)评分、反流症状指数评分量表(RSI)评分、食管下端括约肌压力、胃食管反流病健康相关生活质量量表(GERD-HRQL)评分。结果治疗后,观察组酸反流次数、弱酸反流次数、非酸性反流次数均少于对照组(P均<0.05)。治疗后,观察组酸反流时间、最长反流时间短于对照组(P<0.05)。治疗后,观察组液体反流、气体反流发生频率低于对照组(P<0.05)。治疗后,观察组RDQ、RSI评分低于对照组(P<0.05)。治疗后,观察组食管下端括约肌压力高于对照组(P<0.05)。治疗后,观察组生活质量评分低于对照组(P<0.05)。结论内镜下贲门缩窄术联合艾司奥美拉唑用于反流性食管炎合并食管裂孔疝,可增加食管下端括约肌压力,改善反流症状,提高生活质量。Objective To analyze the clinical effect of endoscopic cardial constriction combined with esomeprazole on patients with reflux esophagitis complicated by hiatal hernias.Methods A total of 146 patients with reflux esophagitis combined with hiatal hernias who were treated in Anyang People’s Hospital from March 2021 to March 2023 were selected for the cohort study.And they were divided into the control group and the observation group according to the random number table method,with 73 cases in each group.The control group was treated with esomeprazole,hydrotalcite and mosapride citrate.The observation group was treated with endoscopic cardial constriction combined with esomeprazole.The number of reflux episodes,reflux time,reflux frequency,reflux disease questionnaire(RDQ)score,reflux symptom index(RSI)score,lower esophageal sphincter pressure,health related quality of life scale for gastroesophageal reflux disease(GERD-HRQL)score were compared between the two groups.Results After treatment,the number of acid reflux,weak acid reflux and non-acid reflux in the observation group were less than those in the control group(all P<0.05).After treatment,the acid reflux time and the longest reflux time in the observation group were shorter than those in the control group(P<0.05).After treatment,the frequencies of liquid reflux and gas reflux in the observation group were lower than those in the control group(P<0.05).After treatment,the RDQ and RSI scores of the observation group were lower than those of the control group(P<0.05).After treatment,the lower esophageal sphincter pressure in the observation group was higher than that in the control group(P<0.05).After treatment,the quality of life score of the observation group was lower than that of the control group(P<0.05).Conclusions Endoscopic cardial constriction combined with esomeprazole for reflux esophagitis complicated by hiatal hernias can increase the lower esophageal sphincter pressure,alleviate reflux symptoms,and improve the quality of life.

关 键 词：食管裂孔疝 反流性食管炎 内镜下贲门缩窄术 艾司奥美拉唑 

分 类 号：R655.4[医药卫生—外科学]