肥胖合并胃食管反流病患者的术前诊断分型与胃减容手术后临床预后及并发症的相关性分析  

Correlation analysis between preoperative diagnosis and classification of obesity patients complicated with gastroesophageal reflux disease and clinical prognosis and complications after gastric volume reduction surgery

作　　者：崔莹[1] 王凤侠 李丽[1] 曹新岭[1] CUI Ying;WANG Fengxia;LI Li;CAO Xinling(The First Affiliated Hospital of Xinjiang Medical University,Xinjiang Wulumuqi 830000,China)

机构地区：[1]新疆医科大学第一附属医院,新疆乌鲁木齐830000

出　　处：《中国实验诊断学》2025年第2期141-145,共5页Chinese Journal of Laboratory Diagnosis

基　　金：省部共建中亚高发病成因与防治国家重点实验室开放课题项目(SKL-HIDCA-2020-43)。

摘　　要：目的研究旨在分析肥胖合并胃食管反流病(Gastroesophageal reflux disease,GERD)患者术前诊断分型与胃减容手术后临床预后及并发症的相关性。方法纳入2022年1月至2023年6月在新疆医科大学第一附属医院接受胃减容手术的126例肥胖合并GERD患者,分为观察组和对照组,每组63例。检测术前和术后1个月、3个月、6个月的BMI、(Gastroesophageal Reflux Disease Symptom Rating Scale,GSRS)评分、内镜检查及血液生化指标,使用Spearman相关系数分析BMI与其他临床指标的相关性,并通过ROC曲线评估各指标对并发症发生的预测效果。结果手术后,观察组的BMI显著下降,从术前的平均34.50降至术后6个月的28.20(P<0.001)。GSRS评分从术前的18.50下降至术后3个月的12.30(P<0.001)。内镜检查结果显示反流性食管炎的发生率术前为68%,术后6个月降至35%(P<0.05)。生化指标中,ALT术前为45.30 U/L,术后6个月降至33.60 U/L(P<0.01)。Spearman相关分析显示BMI与GSRS评分(r=0.52,P<0.01)、内镜检查结果(r=0.47,P<0.01)及ALT水平(r=0.55,P<0.01)呈正相关。ROC曲线分析结果显示BMI截断值为30.25,灵敏度80%,特异度75%;GSRS评分截断值为15.50,灵敏度78%,特异度72%。结论BMI、GSRS评分、内镜检查及生化指标在预测肥胖合并GERD患者术后并发症方面具有显著价值。术前综合评估这些指标可优化患者的术后管理,有助于提高预后效果并降低并发症发生率。Objective To analyze the correlation between preoperative diagnosis and classification of obese patients with gastroesophageal reflux disease(GERD)and clinical prognosis and complications after gastric volume reduction surgery.Methods From January 2022 to June 2023,126 obese patients with GERD who underwent gastric volume re-duction surgery in a hospital were divided into observation group and control group,with 63 cases in each group.The preoperative and postoperative BMI,(gastroesophageal disease syndrome rating scale,GSRS)score,endoscopic exami-nation and blood biochemical indexes were detected.The correlation between BMI and other clinical indexes was ana-lyzed by Spearman correlation coefficient,and the predictive effect of each index on complications was evaluated by ROC curve.Results After the operation,the BMI of the observation group decreased significantly,from an average of 34.50 before operation to 28.20 six months after operation(P<0.001).The GSRS score decreased from 18.5o before operation to 12.30 three months after operation(P<0.001).Endoscopic examination showed that the incidence of re-flux esophagitis was 68%before operation and decreased to 35%6 months after operation(P<0.05).Among bio-chemical indexes,ALT was 45.30 U/L before operation and decreased to 33.60 U/L 6 months after operation(P<0.01).Spearman correlation analysis showed that BMI was positively correlated with GSRS score(r=0.52,P<0.01),endoscopic examination results(r=0.47,P<0.01)and ALT level(r=0.55,P<0.01).ROC curve analysis showed that the cutoff value of BMI was 30.25,the sensitivity was 80%,and the specificity was 75%.The cutoff value of GSRS score was 15.50,the sensitivity was 78%,and the specificity was 72%.Conclusion BMI,GSRS score,endoscopy and biochemical indexes have significant value in predicting postoperative complications of obese patients with GERD.Com-prehensive evaluation of these indexes before operation can optimize the postoperative management of patients,improve the prognosis and reduce the incidence of complic

关 键 词：胃食管反流病 胃减容手术 术后并发症 体重指数 

分 类 号：R656.61[医药卫生—外科学] R571[医药卫生—临床医学]