| 刘 佳,张 伟,仇 明,王 强,李 伟,岑晓霞.腹腔镜胃底折叠术和食管裂孔疝修补术在胃食管反流病患者中的临床应用研究[J].,2018,(3):549-552 |
| 腹腔镜胃底折叠术和食管裂孔疝修补术在胃食管反流病患者中的临床应用研究 |
| Gastroesophageal Reflux Disease: Clinical Application of Laparoscopic Fundoplication and Hiatal Hernia Repair |
| 投稿时间：2017-09-23 修订日期：2017-10-18 |
| DOI：10.13241/j.cnki.pmb.2018.03.033 |
| 中文关键词: 胃食管反流病 腹腔镜 胃底折叠术 食管裂孔疝修补术 应用效果 |
| 英文关键词: Gastroesophageal reflux disease Laparoscopy Fundoplication Hiatal hernia repair Application effect |
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| 中文摘要: |
| 摘要 目的：研究腹腔镜胃底折叠术和食管裂孔疝修补术在胃食管反流病的临床应用效果。方法：选择2009年5月～2016年8月于我院接受腹腔镜胃底折叠术和食管裂孔疝修补术治疗的92例胃食管反流病患者作为研究对象，并根据不同的胃底折叠术分为Nissen组54例和Toupet组38例。其中Nissen组患者采用Nissen360°术式治疗，Toupet组患者采用Toupet270°术式治疗。分别比较两组患者术后恢复情况、术后症状缓解情况、手术满意度以及吞咽困难发生情况。结果：两组患者术后Visick评分等级为Ⅰ～Ⅱ级占比高于术前，而Ⅲ～Ⅳ级占比低于术前，差异均有统计学意义（P＜0.05）。Nissen组术后症状缓解率为90.74%（49/54），与Toupet组的81.58%（31/38）相比，差异无统计学意义（P＞0.05）。Nissen组手术满意度为92.59%（50/54），与Toupet组的84.21%（32/38）相比，差异无统计学意义（P＞0.05）。Nissen组患者术后1个月吞咽困难发生率为46.30%（25/54），高于Toupet组的23.68%（9/38），差异有统计学意义（P＜0.05）；而两组患者术后6个月吞咽困难发生率比较差异无统计学意义（P＞0.05）。结论：腹腔镜胃底折叠术和食管裂孔疝修补术治疗胃食管反流病具有一定的有效性与安全性，可根据患者具体病情选择Nis- sen360°术式或Toupet270°术式治疗。 |
| 英文摘要: |
| ABSTRACT Objective: To study the clinical effect of laparoscopic fundoplication and hiatal hernia repair in patients with gastroe- sophageal reflux disease. Methods: A total of 92 patients with gastroesophageal reflux disease, who underwent laparoscopic fundoplica- tion and hiatal hernia repair in Changzheng Hospital of Second Military Medical University from May 2009 to August 2016, were selected and divided into Nissen group (54 cases) and Toupet group (38 cases) according to different fundoplication. The Nissen group was treated with Nissen360 degrees operation, and the Toupet group was treated with Toupet 270 degrees operation. The postoperative recovery, postoperative symptom relief, operation satisfaction and dysphagia were compared between the two groups. Results: The proportion of grade I to II of the Visick scores in the two groups was higher than that before operation,but the proportion of grade III to IV was lower than that before operation, the differences were statistically significant (P<0.05). The remission rate of postoperative symptoms in Nissen group was 90.74% (49/54), compared with 81.58% (31/38) in Toupet group, the difference was not statistically significant (P>0.05). The satisfaction rate of operation in Nissen group was 92.59% (50/54), compared with 84.21% (32/38) in Toupet group, the difference was not statistically significant (P>0.05). The incidence of dysphagia in Nissen group 1 month after operation was 46.30% (25/54), which was higher than that of Toupet group (23.68%) (9/38), and the difference was statistically significant (P<0.05); there was no significant differ- ence in the incidence of dysphagia between the two groups 6 months after operation (P>0.05). Conclusion: Laparoscopic fundoplication and hiatal hernia repair are effective and safe in the treatment of gastroesophageal reflux disease, and Nissen360 degree operation or Toupet270 degree surgical treatment can be selected according to the patient's specific condition. |
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