摘要
目的探讨经口内镜下贲门缩窄术治疗轻、重度反流性食管炎的效果。方法46例反流性食管炎患者均行经口内镜下贲门缩窄术治疗,依据洛杉矶分级标准,其中A~B级患者29例为轻度组,C~D级患者17例为重度组。比较2组术前、术后2个月、术后1年GerdQ评分及术后2个月、术后1年疗效满意率;术前、术后1年行24 h食管pH监测,记录DeMeester评分、酸暴露时间百分比(acid exposure time,AET),术后1年行胃镜检查观察食管黏膜改善情况,计算食管黏膜改善率。结果术前轻度组GerdQ评分[(11.10±1.82)分]、DeMeester评分[33.5(21.5,62.4)分]、AET[9.6(5.3,19.8)%]与重度组[(11.12±1.22)分、37.5(23.9,67.7)分、10.6(7.1,22.1)%]比较差异均无统计学意义(P>0.05);术后2个月轻度组、重度组GerdQ评分[(5.21±1.90)、(6.29±2.29)分]均低于术前(P<0.05),2组比较差异无统计学意义(P>0.05);术后1年轻度组GerdQ评分[(5.97±2.11)分]、DeMeester评分[16.7(12.4,36.3)分]、AET[5.3(3.4,8.9)%]均低于术前(P<0.05),重度组GerdQ评分[(9.76±3.17)分]、DeMeester评分[28.3(17.1,73.2)分]、AET[7.3(5.2,24.4)%]与术前比较差异均无统计学意义(P>0.05),且均高于轻度组(P<0.05)。轻度组术后1年疗效满意率(89.7%)及食管黏膜改善率(93.1%)均高于重度组(47.1%、64.7%)(P<0.05),术后2个月疗效满意率(93.1%)与重度组(76.5%)比较差异无统计学意义(P>0.05)。结论经口内镜下贲门缩窄术治疗轻度反流性食管炎酸反流程度减轻,食管黏膜糜烂、溃疡明显改善。
Objective To evaluate the efficacy of peroral endoscopic cardial constriction(PECC)on mild or severe reflux esophagitis.Methods Forty-six patients with reflux esophagitis received PECC.According to the Los Angeles(LA)classification,29 patients with LA-A and LA-B were as mild group,and 17 patients with LA-C and LA-D were as severe group.The GerdQ scores before operation,2 months after operation and 1 year after operation,and satisfaction rates 2 months after operation and 1 year after operation were compared between two groups.The DeMeester score and acid exposure time(AET)were monitored before operation and 1 year after operation by 24-h esophageal pH monitoring.One year after operation,gastroscopy was done to observe the improvement of esophageal mucosa.Results Before operation,there were no significant differences in the GerdQ score,DeMeester score and AET value between mild group[11.10±1.82,33.5(21.5,62.4),9.6(5.3,19.8)%]and severe group[11.12±1.22,37.5(23.9,67.7),10.6(7.1,22.1)%](P>0.05).The GerdQ scores 2 months after operation(5.21±1.90,6.29±2.29)were lower than those before operation in mild group and severe group(P<0.05),and showed no significant difference between two groups(P>0.05).The GerdQ score,DeMeester score and AET value were lower 1 year after operation[5.97±2.11,16.7(12.4,36.3),5.3(3.4,8.9)%]than those before operation in mild group(P<0.05),were lower in mild group than those in severe group[9.76±3.17,28.3(17.1,73.2),7.3(5.2,24.4)%],and showed no significant differences 1 year after operation in severe group compared with those before operation(P>0.05).The satisfaction rate and the esophageal mucosa improvement rate 1 year after operation were higher in mild group(89.7%,93.1%)than those in severe group(47.1%,64.7%)(P<0.05),while the satisfaction rate showed no significant differences 2 months after operation between mild group(93.1%)and severe group(76.5%)(P>0.05).Conclusion PECC alleviates the reflux,and mucosal ulcer and erosion in patients with mild reflux esophagitis.
作者
任梦华
孙淑珍
王红建
李冰清
REN Meng-hua;SUN Shu-zhen;WANG Hong-jian;LI Bing-qing(Department of Gastroenterology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan 450052,China)
出处
《中华实用诊断与治疗杂志》
2022年第8期841-844,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省高等学校重点科研项目(19A320087)。
