套扎联合经口内镜下贲门缩窄术对难治性胃食管反流病患者症状改善的影响研究  

Effect of ligation combined with peroral endoscopic cardial constriction on symptom improvement in patients with refractory gastroesophageal reflux disease

作　　者：徐汤舟 邱冰峰[1] 徐骐 毛吉波[1] 曲俊翰 Xu Tangzhou;Qiu Bingfeng;Xu Qi;Mao Jibo;Qu Junhan(Department of Gastroenterology,Zhejiang Zhoushan Hospital,Zhoushan 316004,China)

机构地区：[1]浙江省舟山医院消化内科,舟山316004

出　　处：《中国医师进修杂志》2025年第2期116-120,共5页Chinese Journal of Postgraduates of Medicine

基　　金：舟山市科技计划项目(2020C31093)。

摘　　要：目的探讨套扎联合经口内镜下贲门缩窄术(PECC)对难治性胃食管反流病(GERD)患者症状改善的影响。方法回顾性选取2019年3月至2023年3月在浙江省舟山医院治疗的难治性GERD患者42例,其中21例患者采用常规药物治疗(对照组),21例患者在对照组治疗的基础上行套扎联合PECC(研究组),比较两组治疗前后的反流次数和时间、症状评分情况、反流发生频率及临床疗效。结果研究组治疗后最长反流时间、酸反流时间、反流总次数、酸反流次数、非酸性反流次数及弱酸反流次数均低于对照组[(2.14±0.12)min比(4.23±1.03)min、(49.22±5.13)min比(60.15±6.21)min、(25.13±2.11)次比(30.53±3.52)次、(8.11±0.63)次比(9.84±0.85)次、(6.11±0.51)次比(8.01±0.72)次、(10.11±1.12)次比(23.14±1.29)次],差异有统计学意义(P<0.05)。研究组治疗后GERD健康生命质量量表、反流性疾病问卷及反流症状指数量表评分均低于对照组[(5.19±0.42)分比(11.34±1.35)分、(4.15±0.34)分比(10.66±1.63)分、(3.27±0.24)分比(7.51±0.56)分],差异有统计学意义(P<0.05)。研究组治疗后液气混合反流、液体反流、气体反流发生频率低于对照组[(10.14±1.15)次/24 h比(14.39±1.33)次/24 h、(5.12±0.42)次/24 h比(6.06±0.74)次/24 h、(7.62±0.72)次/24 h比(10.43±1.34)次/24 h],差异有统计学意义(P<0.05)。研究组治疗后总有效率高于对照组[90.48%(19/21)比57.14%(12/21)],差异有统计学意义(χ^(2)=5.02,P<0.05)。结论难治性GERD患者应用套扎联合PECC效果理想,可以有效改善患者的反流发生频率和症状评分情况,同时可以降低反流次数和时间,提高临床疗效。Objective To investigate the effect of ligation combined with peroral endoscopic cardial constriction(PECC)on the improvement of symptoms in patients with refractory gastroesophageal reflux disease(GERD).Methods The clinical data of 42 patients with refractory GERD admitted to Zhejiang Zhoushan Hospital from March 2019 to March 2023 were collected retrospectively.Among them,21 patients were treated with conventional drugs(control group),and 21 patients were treated with ligation combined with PECC on the basis of the control group(study group).The frequency and time of reflux,symptom score,frequency of reflux occurrence,and clinical efficacy of the two groups were compared before and after treatment.Results After treatment,the longest regurgitation time,acid regurgitation time,total regurgitation times,acid regurgitation times,non-acid regurgitation times and weak acid regurgitation times in the study group were lower than those in the control group:(2.14±0.12)min vs.(4.23±1.03)min,(49.22±5.13)min vs.(60.15±6.21)min,(25.13±2.11)times vs.(30.53±3.52)times,(8.11±0.63)times vs.(9.84±0.85)times,(6.11±0.51)times vs.(8.01±0.72)times,(10.11±1.12)times vs.(23.14±1.29)times,there were statistical differences(P<0.05).After treatment,the scores of GERD Health Quality of Life Scale(GERD-HRQL),Reflux Disease Questionnaire(RDQ)and Reflux Symptom Index Scale(RSI)in the study group were lower than those in the control group:(5.19±0.42)scores vs.(11.34±1.35)scores,(4.15±0.34)scores vs.(10.66±1.63)scores,(3.27±0.24)scores vs.(7.51±0.56)scores,there were statistical differences(P<0.05).After treatment,the frequency of liquid-gas reflux,liquid reflux and gas reflux in the study group after treatment were lower than those in the control group:(10.14±1.15)times/24 h vs.(14.39±1.33)times/24 h,(5.12±0.42)times/24 h vs.(6.06±0.74)times/24 h,(7.62±0.72)times/24 h vs.(10.43±1.34)times/24 h,there were statistical differences(P<0.05).The total effective rate in the study group was higher than that in the control group

关 键 词：胃食管反流 内镜下贲门缩窄术 体征和症状 消化系统 治疗结果 

分 类 号：R655.4[医药卫生—外科学]