中国胃食管反流病的诊疗进展

Advances in the Diagnosis and Treatment of Gastroesophageal Reflux Disease in China

胃食管反流病(GERD)是常见的慢性消化系统疾病。在中国,GERD的患病率高达8.7%。由于GERD临床表现多样化,其诊断对于临床医师是一大挑战。中国指南提出洛杉矶B级及以上食管炎或食管酸暴露百分比超过4%可确诊GERD。另外,尽管抑酸药物是GERD的一线治疗方式,但仍有高达50%的患者服药后症状无法有效缓解。药物治疗无效的患者通常选择接受内镜下抗反流手术,但是一部分患者术后仍需服用抗反流药物甚至接受二次手术以控制GERD症状。本文总结了目前中国GERD的诊断和治疗现状,为临床医师提供一定参考。

Gastroesophageal reflux disease(GERD)is one of the most common chronic gastrointestinal disorders.The prevalence of GERD in China is 8.7%.Due to the diverse manifestations,the diagnosis of GERD is a challenge for clinicians.Chinese guideline proposed that patients with Los Angeles grade B/C/D esophagitis or acid exposure time>4%could be diagnosed as GERD.Although acid suppressive therapy is the first-line treatment for GERD,up to 50%of patients did not report effective symptom relief despite medications.Such patients typically undergo endoscopic anti-reflux surgery,but some still need to take anti-reflux medication or even undergo a secondary surgery to control GERD symptoms.This article summarized the current status of diagnosis and treatment of GERD in China,offering valuable insights for clinical physicians.