兰索拉唑联合伊托必利辅助腹腔镜食管裂孔疝修补术对胃食管反流病合并食管裂孔疝患者抗反流效果及生活质量的影响

Effect on anti-reflux effect and quality of life in patients with GERD complicated with hiatus herniausing lansoprazole combined with itopride assisted laparoscopic repair of esophageal hiatus hernia

目的探究兰索拉唑联合伊托必利辅助腹腔镜手术对胃食管反流病(GERD)合并食管裂孔疝(HH)患者抗反流效果及生活质量的影响。方法选取内蒙古包钢医院2015年1月至2018年6月收治的120例GERD合并HH患者为研究对象,行腹腔镜食管裂孔疝修补术,根据患者术后所采用的治疗方式,将其分别纳入试验组(60例)和对照组(60例)。试验组采用腹腔镜食管裂孔疝修补术+兰索拉唑联合伊托必利治疗,对照组采用腹腔镜食管裂孔疝修补+安慰剂治疗。比较2组患者的黏膜愈合率、抗反流效果及生活质量。结果试验组的黏膜总愈合率为93.33%,对照组的黏膜总愈合率为78.33%,差异有统计学意义(P<0.05)。手术后6个月,2组患者的反流性疾病问卷(RDQ)中烧心、胸痛、反酸和反流的评分显著低于治疗前(P<0.05),且试验组的各项评分低于对照组(P<0.05)。术后2组患者的消化病生活质量指数(GLQI)评分均升高,且试验组的GLQI评分显著高于对照组(P<0.05)。结论兰索拉唑联合伊托必利辅助腹腔镜食管裂孔疝修补术治疗GERD合并HH患者效果较好,可有效减少反流,并促进胃黏膜修复,进而提高患者生活质量,具有临床推广价值。

Objective To explore the effect on anti-reflux effect and quality of life in patients with gastroesophageal reflux disease(GERD)complicated with hiatal hernia(HH)using lansoprazole combined with itopride assisted laparoscopic repair of esophageal hiatus hernia.Methods A total of 120 patients with GERD complicated with HH who underwent laparoscopic hiatal hernia repair in Baogang Hospital were enrolled into the experimental group(n=60 cases)and the control group(n=60 cases)according to the treatment methods adopted after surgery.The experimental group was treated with laparoscopic hiatal hernia repair+lansoprazole combined with itopride,while the control group was treated with laparoscopic hiatal hernia repair+placebo.The mucosal healing rate,anti-reflux effect and quality of life were compared between the two groups.Results After treatment,the total healing rate of mucosa in the laparoscopy group(93.33%)was higher than thatin the laparotomy group(78.33%),with significant difference(P<0.05).6 months after operation,the scores of heartburn,chest pain,belching and reflux in reflux disease questionnaire(RDQ)in the two groups were significantly lower than those before treatment(P<0.05),and the above scores in the observation group were lower than those in control group(P<0.05).The scores of gastrointestinal quality of life index(GLQI)in the two groups increased after operation,and the score of GLQI in the observation group was significantly higher than that in control group(P<0.05).Conclusion Lansoprazole combined with itopride assisted laparoscopic repair of esophageal hiatal hernia is effective in the treatment of GERD combined with HH.It can effectively reduce reflux and promote gastric mucosal repair,and it is worthy for clinical application.