胃袖状切除术后发生胃食管反流病临床影响因素分析  

Study on the clinical influencing factors of gastroesophageal reflux disease after sleeve gastrectomy

作　　者：唐欣 周福庆 陈宇涵 董世梁 王存川[1] 董志勇[1] TANG Xin;ZHOU Fu-qing;CHEN Yu-han;DOND Shi-liang;WANG Cun-chuan;DOND Zhi-yong(Weight Loss Center of the First Affiliated Hospital of Jinan University,Guangzhou 510000,China)

机构地区：[1]暨南大学附属第一医院减重中心,广东广州510000

出　　处：《中国实用外科杂志》2025年第2期227-230,235,共5页Chinese Journal of Practical Surgery

基　　金：广东省基础与应用基础研究专题(青年博士“启航”项目)(No.SL2024A04J00854);广州市科技计划项目(No.2024A03J1037)。

摘　　要：目的 探讨胃袖状切除术(SG)后发生胃食管反流病(GERD)的临床影响因素。方法 回顾性分析2022-01-01—2023-12-31于暨南大学附属第一医院减重中心住院行SG病人的病例资料,根据术后3个月是否出现反酸分为反流组及正常组,比较两组病人的术前临床指标,通过逐步回归分析及logistic回归分析探讨导致SG后早期发生GERD的影响因素。结果 共纳入430例行SG病人,术后3个月81例发生GERD,发生率为18.8%。术前正常组(349例)与反流组(81例)病人年龄、性别、体重、体重指数、腹围等临床指标差异无统计学意义(P>0.05);反流组幽门螺杆菌(Hp)感染比例高于正常组,差异有统计学意义(18.5%vs.8.0%,P=0.008)。多因素logistic回归分析结果显示,Hp感染是SG后3个月发生GERD的独立危险因素(OR=2.96,95%CI 1.44~5.92,P=0.002)。结论 Hp感染是SG后发生GERD的独立危险因素。术前建议完善病人的Hp感染检查,术后行Hp根除治疗,对降低SG后GERD的发生率具有潜在参考价值。Objective To explore the clinical influencing factors of gastroesophageal reflux disease(GERD) after sleeve gastrectomy(SG).Methods Retrospectively analyze the medical records of patients who underwent SG at the First Affiliated Hospital of Jinan University from January 1,2022 to December 31,2023.Patients were divided into a reflux group and a normal group according to whether acid reflux occurred 3 months after surgery.The preoperative clinical indicators of the two groups were compared.Stepwise regression analysis and logistic regression analysis were used to explore the influencing factors leading to early GERD after SG.Results A total of 430 patients who underwent SG were included in this study,and 81 patients developed GERD 3 months after surgery,with an incidence of 18.8%.There was no significant difference in clinical indicators such as age,gender,weight,body mass index,and abdominal circumference between the normal group(n=349) and the reflux group(n=81) before surgery(P>0.05);the proportion of Helicobacter pylori(Hp) infection in the reflux group was higher than that in the normal group,with a statistically significant difference(18.5% vs.8.0%,P=0.008).The results of multivariate logistic regression analysis showed that Hp infection was an independent risk factor for GERD 3 months after SG(OR=2.96,95%CI 1.44-5.92,P=0.001).Conclusions Hp infection is an independent risk factor for GERD after SG.Preoperative Hp infection examination and postoperative Hp eradication therapy have potential reference value for reducing the incidence of GERD after SG.

关 键 词：肥胖 胃袖状切除术 胃食管反流病 危险因素 

分 类 号：R6[医药卫生—外科学]