胃食管反流病发生的解剖学基础及手术治疗策略  

The anatomical pathogenesis and treatment strategy of gastroesophageal reflux disease

作　　者：郑铭 鄂一民 陆晨 徐方贵 刘天宇 喻春钊 Zheng Ming;E Yimin;Lu Chen;Xu Fanggui;Liu Tianyu;Yu Chunzhao(Department of General Surgery,Sir Run Run Hospital,Nanjing Medical University,Nanjing211112,China;Department of General Surgery,The Second Affiliated Hospital of Nanjing Medical University,Nanjing210011,China)

机构地区：[1]南京医科大学附属逸夫医院普通外科,南京211112 [2]南京医科大学第二附属医院普通外科,南京210011

出　　处：《中华消化外科杂志》2024年第11期1465-1470,共6页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金(82373293);国家重点研发计划(2018YFE0127300);江苏省“333工程”培养资金(BRA2020091);江苏省科技计划重点项目(BE2019759);江苏省卫生健康委员会研究项目(ZD2022063)。

摘　　要：胃食管反流病(GERD)是一种常见的消化系统疾病,主要表现为胃、十二指肠内容物反流至食管或者食管外,导致系列临床症状。食管胃连接部是抗反流功能的主要区域,其中食管下端括约肌、膈肌脚、膈食管韧带和His角等解剖结构的异常是GERD发生的重要因素。基于这些解剖结构的重建和修复手术是治疗GERD的有效方法,其丰富的手术方式各有其优势和侧重点。笔者以解剖学视角阐述GERD发生机制与手术方式的合理选择。Gastroesophageal reflux disease(GERD)is a prevalent disorder within the digestive system,characterized by the regurgitation of gastric and duodenal contents into the esophagus or extraesophageal regions,leading to a spectrum of clinical symptoms.The esophagogastric junction serves as the principal area for anti-reflux function,with anomalies in anatomical structures including the lower esophageal sphincter,the crural diaphragm,the phrenoesophageal ligament,and the angle of His as significant factors in the development of GERD.Reconstructive and reparative surgeries based on above anatomical structures are effective methods for treating GERD,with a variety of surgical approaches each offering distinct advantages and focal points.The authors elucidate the anatomical pathogenesis and rational selection of surgical methods for GERD.

关 键 词：胃食管反流病 食管裂孔疝 发病机制 抗反流手术 解剖学 疗效 

分 类 号：R655.4[医药卫生—外科学]