应用内镜下贲门部套扎紧缩成形术治疗胃食管反流病的临床疗效

Clinical effect of endoscopic cardial ligation and constriction for gastroesophageal reflux disease

摘要:

目的 探究内镜下贲门部套扎紧缩成形术治疗胃食管反流病的临床疗效。方法 选取2016年3月－2018年2月郑州颐和医院收治的胃食管反流病患者100例作为研究对象，分为射频组和套扎组，每组各50例患者。射频组患者行内镜下射频技术治疗，套扎组患者采用内镜下贲门部套扎紧缩成形术治疗。比较两组患者治疗效果、术前和术后6个月食管测压和反流情况以及并发症发生率。结果 套扎组患者治疗效果（98.00%）明显优于射频组（76.00%），两组比较，差异有统计学意义（P < 0.05）；套扎组患者术后6和12个月24 h反流时间、反流次数和胃食管反流病自测量表（GERD-Q）评分明显低于术前，且套扎组低于射频组，差异均有统计学意义（P < 0.05）；套扎组术后6和12个月食管括约肌压力和食管残余压明显高于术前，且套扎组高于射频组，两组比较，差异均有统计学意义（P < 0.05）；套扎组术后并发症发生率（10.00%）也明显低于射频组（34.00%），两组比较，差异有统计学意义（P < 0.05）。结论 内镜下贲门部套扎紧缩成形术治疗胃食管反流病效果较好，可以缩短胃反流时间、减少反流次数、缓解症状、增加食管括约肌压力和食管残余压、减少并发症的发生率。

Abstract:

Objective To explore the clinical effect of endoscopic cardioplasty for gastroesophageal reflux disease.Methods 100 patients with gastroesophageal reflux disease from March 2016 to February 2018 were selected as the research object. They were divided into radio frequency group and ligation group. 50 patients in each group. Radio frequency group underwent endoscopic radio frequency treatment, and ligation group underwent endoscopic cardiac ligation and constriction plasty. The therapeutic effect, esophageal manometry and reflux before and 6 months after operation, and the incidence of complications were compared between the two groups.Results The results showed that the therapeutic effect of the ligation group (98.00%) was significantly better than that of the radio frequency group (76.00%) and the difference was significant (P < 0.05). The 24-hour reflux time, reflux frequency and GERD-Q score of the ligation group at 6 months and 12 months after the operation were significantly lower than those of the pre-operation. The ligation group was lower than the radio frequency group, the difference was statistically significant (P < 0.05); The sphincter pressure and esophageal residual pressure at 6 and 12 months after operation in ligation group were significantly higher than those before operation. The ligation group was higher than the radio frequency group, the difference was statistically significant (P < 0.05). The complications of ligation group (10.00%) was significantly lower than that in radio frequency group (34.00%), the difference was statistically significant between the two groups (P < 0.05).Conclusion Endoscopic cardiac ligation and constriction angioplasty has a better therapeutic effect on gastroesophageal reflux disease. It can shorten the time of gastroesophageal reflux, increase the frequency and symptoms of reflux, reduce sphincter pressure and esophageal residual pressure, and reduce the incidence of complications.