难治性胃食管反流病的诊治

Diagnosis and treatment of refractory gastroesophageal reflux

近年来,针对经标准质子泵抑制剂(PPI)治疗后症状仍无法缓解的这部分胃食管反流病患者,专家们提出了"难治性胃食管反流病(RGERD)"的概念。通过对RGERD病例的研究,发现24 h pH-阻抗监测、高分辨率食管测压等新技术有助于临床诊断。治疗上仍以加倍PPI为主要措施,对于非酸反流的患者手术、针灸等治疗可能有效。本文就难治性胃食管反流病的诊治进展作一概述。

Recent years, for those GERD patients whose symptoms can not be alleviated by standard proton pump in- hibitor （PPI） therapy, the experts put forward the concept of refractory GERD. New technologies such as 24 h pH-im- pedance monitoring, high-resolution esophageal manometry contribute to the clinical diagnosis of refractory GERD. Treatment in clinical practice has been primarily focused on doubling the PPI dose. Other therapeutic strategies such as surgery, acupuncture should be considered and tailored. This article is a review for progress of diagnosis and treatment of refractory gastroesophageal reflux.