肥胖病人胃食管反流病治疗

Treatments for gastroesophageal reflux disease in patients with obesity

由于肥胖导致抗反流屏障功能减弱,肥胖病人易患胃食管反流病(GERD)。对于肥胖病人的GERD治疗,改变生活方式、服用药物和抗反流手术效果有限,目前最有效的方式是实施减重手术。目前,减重手术中胃旁路术抗反流效果理想;而对于胃袖状切除术,尽管存在争议,但其仍可作为胃食管反流治疗选择之一;另外,也可尝试其他改良术式。减重手术后出现胃食管反流须查明原因并积极治疗,必要时行修正手术。

Gastroesophageal reflux disease(GERD)is pronouncedly increased among obese population due to the incompetence of anti-reflux barrier resulting from adiposity.While lifestyle changes,medications and anti-reflux surgery have limited effects,bariatric surgery is the best treatment for GERD in patients with obesity.Roux-en-Y gastric bypass is an ideal procedure and sleeve gastrectomy can also be accepted as an option despite its controversy over GERD.Besides,some combination surgeries have emerged to be worth attempts.In case of the postoperative reflux,causes for that should be found and treated.Revisional surgery can be performed when it is necessary.