胃镜下微量射频治疗胃食管反流病的 疗效观察及安全性分析

Effect and safety of endoscopic micro-radio frequency in treating gastro-esophageal reflux disease

摘要:

目的 研究胃镜下微量射频治疗治疗胃食管反流病的效果及安全性。方法 选择2011年1月～2012年12月在该院接受胃镜下微量射频治疗的胃食管反流病患者86例为研究对象，观察治疗前后治疗效果、临床症状积分、安全性评估。结果 86例患者中，6个月随访84例，治愈25例，缓解36例，部分缓解18例，无效5例，治疗有效率94.05%，12个月随访结果与6个月比较差异无显著性；治疗后6个月患者GERD-HRQL积分（7.32±4.15）、DeMeester评分（15.68±5.12）、pH≤4，反流次数（48.43±7.42）、反酸症状（0.92±0.12）、烧心症状（0.82±0.12）及胸痛症状（0.72±0.12）明显低于治疗前，食管炎分级明显好于治疗前；手术术中、术后收缩压、舒张压及心率均较术前有所下降，但均在正常值范围内；麻醉过程与手术过程出现躁动8例（9.3%），呛咳3例（3.49%），呃逆4例（4.65%），出现黏膜轻度损伤2例（2.33），黏膜少量出血3例（3.49%），术后发热2例（2.33%），均不需要干预治疗，无黏膜撕裂、穿孔、呼吸抑制及吸入性肺炎的并发症。结论 胃镜下射频治疗有助于改善临床症状，提高治疗效果，且安全性能较好，对于不能耐受药物治疗的患者具有积极的临床价值。

Abstract:

【Objective】 To study the effect and safety of endoscopic micro-radio frequency in treating gastro-esophageal reflux disease. 【Methods】 form January 2011 to December 2012, 86 cases with gastroesophageal reflux disease were given trace radiofrequency therapy under gastroscope, treatment effect, clinical symptoms integral, safety assessment were observed. 【Results】 86 cases of patients, 6 months follow-up of 84 cases, 25 cases were cured, 36 cases alleviated, 18 cases partial response alleviated, 5 cases ineffective, treatment effectiveness of 94.05%, there was no statistically significant difference between 12 months follow-up results and six months; after 6 months treatment, GERD-HRQL integral (7.32-4.15), DeMeester score (15.68+/-5.12), PH≤4 time of reflux (48.43+7.42), acid reflux (0.92 + 0.12), heartburn (0.82+0.12) chest pain (0.72+0.12) were significantly lower than before treatment, esophagitis classification was significantly better than that before treatment; Intraoperative and postoperative systolic pressure, diastolic blood pressure and heart rate were declined compared with preoperative , but all within normal range; Process of anesthesia and surgery agitation during 8 cases (9.3%), choking cough in 3 patients (3.49%), hiccups in 4 cases (4.65%), mucosal injury in 2 cases (2.33), mucosal bleeding in 3 patients (3.49%), 2 cases of postoperative fever (2.33%), and didn't require intervention treatment, no mucosal laceration and perforation, respiratory depression, complications of aspiration pneumonia. 【Conclusion】 Under gastroscope radiofrequency treatment helps to improve the clinical symptoms and treatment effect, and safety performance is good, haspositive clinical value for the patients who can't tolerate drug treatment .