摘要
目的观察腹腔镜Toupet胃底折叠术对治疗老年食管裂孔疝合并胃食管反流病的临床疗效。方法 70例老年食管裂孔疝合并胃食管反流病患者,均在腹腔镜下行食管裂孔疝修补联合Toupet胃底折叠术治疗。观察术前和术后6个月患者食管反流情况、食管压力及并发症发生情况。结果术后6个月,患者24 h内反流时间短于术前,反流次数少于术前,胃食管反流病自测量表(GERDQ)评分低于术前,差异均具有统计学意义(P<0.05)。术后6个月,患者食管下括约肌压力和食管残余压均明显高于术前,松弛率及无效吞咽率明显低于术前,差异具有统计学意义(P<0.05)。患者术后6个月并发症发生相对较少,其中吞咽困难6例(8.6%),腹胀4例(5.7%),腹泻2例(2.9%),慢性疼痛3例(4.3%)。结论腹腔镜Toupet胃底折叠术可有效的提高老年食管裂孔疝合并胃食管反流病患者的临床治疗效果,值得临床推广运用。
Objective To observe the clinical efficacy of laparoscopic Toupet fundoplication in the treatment of elderly hiatal hernia complicated with gastroesophageal reflux disease. Methods A total of 70 elderly patients with hiatal hernia and gastroesophageal reflux disease all received laparoscopic esophageal hiatal hernia repair and Toupet fundoplieation. The esophageal reflux, esophageal pressure and complications were observed before operation and 6 months after operation. Results In postoperative 6 months, patients had 24 h reflux time shorter than before operation, less reflux times than before operation and lower gastroesophageal reflux disease questionnaire （GERDQ） score than before operation. Their difference had statistical significance （P〈0.05）. In postoperative 6 months, patients had obviously higher esophageal sphincter pressure and esophageal residual pressure than before operation, and obviously lower relaxation rate and ineffective swallowing rate than fiefore operation. Their difference had statistical significance （P〈0.05）. Patients had less occurrence of complications in postoperative 6 months, including 6 dysphagia cases （8.6%）, 4 abdominal distention cases （5.7%）, 2 diarrhea cases （2.9%）, 3 chronic pain cases （4.3%）. Conclusion Laparoscopic Toupet fundoplication can effectively improve the clinical treatment effect of elderly hiatal hernia and gastroesophageal reflux disease, and it is worthy of clinical popularization and application.
出处
《中国实用医药》
2017年第24期20-22,共3页
China Practical Medicine
