摘要
目的分析腹腔镜袖状胃切除联合食管裂孔疝修补术(LSG+HHR)对肥胖合并胃食管反流病(GERD)患者的短期治疗效果。方法回顾性分析2019年3月至2020年5月在新疆维吾尔自治区人民医院接受LSG+HHR治疗的43例肥胖合并GERD患者的临床资料,收集患者术前及术后6个月的胃食管反流病调查问卷(GERD-Q)评分、测酸、测压等相关临床资料。结果患者术后6个月体重、BMI与术前相比降低,差异有统计学意义(P<0.05);减重疗效评估效果极佳11例,效果良好23例,有效7例,疗效失败2例,有效率为95.3%。与术前相比,术后Gerd-Q评分显著降低(7.15±0.83 vs 9.84±1.37,t=11.277,P<0.01)。通过对24 h食管pH进行监测,发现患者酸反流(pH值≤4)次数、弱酸反流(4<pH值<7)次数、食管近端酸反流(%)、食管近端弱酸反流(%)以及DeMeester评分等指标,与术前相比显著降低(P<0.01)。食道HRM分析发现食团内部压力(IBP)术后较术前降低,食管远端收缩积分(DCI)较术前增加,差异有统计学意义(P<0.01)。结论 LSG+HHR治疗肥胖合并GERD的效果较好,可达到抗反流减重双重目的,有效防治GERD的发生发展。
Objective To investigate the short-term therapeutic effect of laparoscopic sleeve gastrectomy(LSG)combined with hiatal hernia repair(HHR)in obese patients with gastroesophageal reflux disease(GERD).Methods The clinical data of 43 obese patients with GERD undergoing LSG+HHR in Xinjiang Uygur Autonomous Region People′s Hospital from March 2019 to May 2020 were retrospectively analyzed.GERD-Questionnaire(GERD-Q),acid measurement and high resolution manometry(HRM)were collected before and 6 months after operation.Results The weight and BMI of the patients at 6 months after operation were lower than those before the operation,and the difference was statistically significant(P<0.05);in weight loss evaluation,11 cases were excellent,23 cases were effective,7 cases were effective,2 cases were efficacy failure,and the effective rate was 95.3%.Compared with that before operation,GERD-Q score decreased significantly after operation(7.15±0.83 vs 9.84±1.37,t=11.277,P<0.01).Esophageal 24 h pH monitoring showed that the times of acid reflux(pH≤4)and weak acid reflux(4<pH<7),proximal esophageal acid reflux(%),proximal esophageal weak acid reflux(%)and DeMeester score significantly decreased compared with those before operation(P<0.01).Esophageal HRM analysis showed that bolus internal pressure(IBP)decreased,and distal contraction integral(DCI)increased after operation compared with those before operation(P<0.01).Conclusion In the treatment of obesity complicated with GERD,LSG with HHR is effective and can achieve the dual purpose of anti-reflux and weight-loss,so as to prevent the occurrence and development of GERD.
作者
赛米·赛麦提
马永斌
皮尔地瓦斯
李义亮
克力木
艾克拜尔·艾力
Saimi Saimaiti;MA Yong-bin;Pildivas;LI Yi-liang;Klimu;Aikebaier Ali(Department of Minimally Invasive,Hernia and Abdominal Wall Surgery,the People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830001,China)
出处
《中国临床研究》
CAS
2021年第5期630-633,共4页
Chinese Journal of Clinical Research
关键词
肥胖
胃食管反流病
腹腔镜下袖状胃切除
食管裂孔疝修补术
Obesity
Gastroesophageal reflux disease
Laparoscopic sleeve gastrectomy
Hiatal hernia repair
