经口内镜下贲门缩窄术治疗胃食管反流病的临床研究

Clinical value of peroral endoscopic cardial constriction for gastroesophageal reflux disease

目的研究经口内镜下贲门缩窄术(PECC)治疗胃食管反流病(GERD)的安全性及有效性。方法选择2016年8月至2017年12月在内蒙古医科大学附属医院就诊、符合纳入标准的27例行PECC的GERD患者作为研究对象,比较手术前后食管24hpH-阻抗监测(DeMeester)评分、GERD健康相关生活质量(GERD-HRQL)评分、GERD问卷量表(GERD-Q)症状评分及临床疗效。结果与术前比较,DeMeester评分术后3个月(Z=-6.940,P=0.001)、6个月(Z=-6.307,P=0.001);GERD-HRQL术后3个月Q=11.499,P=0.001)、6个月(t=10.959,P=0.001);GERD-Q术后3个月(t=30.647,P=0.001)、6个月(t=27.217,P=0.001),3项评分均明显降低,差异均有统计学意义。术后3个月、6个月基本治愈率分别为81.5%(22/27)和77.8%(21/27)。结论PECC治疗GERD,短期临床观察疗效显著、安全可行,具有良好的临床应用前景。

Objective To study the safety and efficacy of peroral endoscopic cardial constriction (PECC) for gastroesophageal reflux disease ( GERD). Methods A total of 27 patients with GERD who visited the Affiliated Hospital of Inner Mongolia Medical University from August 2016 to December 2017 and met the inclusion criteria received PECC. The 24 h esophageal pH-resistance monitoring ( DeMeester) scores, GERD health-related quality of life ( GERD-HRQL) scores, GERD-questionnaires ( GERD-Q ) symptom scores and clinical efficacy before and after operation were compared. Results DeMeester score at 3 months (Z=-6. 940, P二0.001) and 6 months (Z=-6. 307, P= 0. 001) after treatment, GERD-HRQL score at 3 months (t=11.499, P = 0. 001) and 6 months (t= 10. 959, P= 0. 001) as well as GERD-Q symptom score at 3 months (Z = 30. 647, P = 0.001) and 6 months (t= 27.217, P = 0. 001) after surgery significantly decreased, compared with those before. The curative rates were 81. 5%( 22/27) and 77. 8%(21/27) at 3 months and 6 months after operation. Conclusion PECC, a new method for the treatment of GERD with good short-term effect, safety and feasibility,can be recommended for clinical application.