Stretta射频治疗以食管外症状为主的胃食管反流病

STRETTA PROCEDURE FOR THE TREATMENT OF GERD MAINLY WITH EXTRA-ESOPHAGEAL SYMPTOMS

探讨胃镜下Stretta射频治疗以食管外症状为主的胃食管反流病的近、中期疗效.回顾性分析自2006年4月至2007年12月期间在我院接受Stretta射频治疗的336例以食管外症状为主的胃食管反流病患者,治疗后随访分析患者的症状缓解率、症状评分和并发症等.结果显示:2例病人在全麻插管下进行,其余都在深度镇静下进行,平均耗时(39.0±5.0)min.术后并发症非常轻微,包括短暂的胸骨后疼痛、轻度发烧、恶心呕吐、短暂吞咽梗阻感等,未出现穿孔、黏膜大片撕脱、大出血、死亡等.共320例(95.2%)患者得到了至少2 a以上的随访,平均随访36.2月.其中102例(31.9%)症状基本消失,138例(43.1%)症状明显缓解,66例(20.6%)症状部分缓解,14例(4.4%)无效,治疗后症状评分明显下降.23例(7.2%)症状有不同程度复发,其中3例行再次射频治疗,6例改行腹腔镜下胃底折叠手术.结果表明:胃镜下Stretta射频治疗是治疗以食管外症状为主的胃食管反流病的一种安全有效的方法.

To explore effectiveness of Stretta radiofrequency（RF） to treat gastroesophageal reflux disease（GERD） with mainly extra-esophageal symptoms.From April 2006 to December 2007,336 consecutive GERD patients with mainly extra-esophageal presentations were treated by the RF.Following ups were done in regard to symptom relief,symptom score,and complications.In total： 332 patients were treated under conscious sedation and two were under general anesthesia,average operating time was 39.0±5.0min.Minor complications included temporary post-procedural retrosternal unease or pain,mild fever,transient nausea/vomiting,and transient dysphagia.There were no post-procedure perforations,serious mucosal lacerations,massive bleeding or deaths.After RF,320（95.2%） patients obtained a more than 2 year（average,36.2 months） follow-up,102（31.9%） patients had complete resolution of symptoms,138（43.1%） patients had symptoms markedly relieved,66（20.6%） had partly relieved,14（4.4%） patients had no effect,the symptom scores fell after RF.Twenty three（7.2%） patients had recurrence of symptoms,a second RF procedure was performed in 3 patients,6 proceeded to laparoscopic fundoplication.It is concluded that Stretta RF is safe and effective in the control of extra-esophageal symptoms in patients with gastro-oesophageal reflux disease.