胃食道逆流性疾病的内膜治疗方法
Jean Paul Galmiche1, Stanislas Bruley des Varannes
1Department of Gastroenterology and Hepatology, CIC INSERM, CHU Nantes, 44093, Nantes, France. galmiche@easynet.fr <galmiche@easynet.fr>
Lancet (London, England)
|April 4, 2003
概括
像射频能量和接这样的内镜治疗对治疗胃食道逆流性疾病 (GORD) 是有前途的,减少了对质子抑制剂 (PPI) 的依赖,在初步研究中并发症最小.
科学领域:
- 胃肠病学 胃肠病学
- 最少侵入性手术的方法
背景情况:
- 胃食道逆流性疾病 (GORD) 是一种严重影响生活质量的慢性疾病,通常使用质子抑制剂 (PPI) 进行治疗.
- 像PPI这样的当前治疗方法是有效的,但成本高昂,并且没有解决潜在的反逆流障碍,而手术带来了显著的发病率和成本效益挑战.
- 内镜技术为慢性GORD提供了潜在的门诊解决方案.
研究的目的:
- 评估慢性GORD两种不同的内镜干预的1年结果:射频能量传递 (斯特雷塔手术) 和内镜 suturing.
- 评估这些内镜治疗对GORD症状,生活质量,药物要求和安全概况的影响.
主要方法:
- 审查了两项前性开放标签研究,其中一项涉及向94名患者的胃食道结节输送射频能量,另一项涉及26名患者的内镜 suturing.
- 两项研究中的患者都有慢性GORD症状,正在接受PPI治疗,并且没有严重的食道炎或大间隙.
- 12个月后的随访评估了症状改善,生活质量,食道酸暴露,以及需要PPI治疗的需要.
主要成果:
- 射频能量传递和内镜合都显示,在1年后,GORD症状和生活质量显著改善.
- 需要PPI治疗的需求大幅下降,在射频治疗后从98%降至30%,在内镜 suturing后从100%降至36%.
- 这两种手术都只带来了轻微的并发症,没有任何需要特别的干预.
结论:
- 内镜治疗,包括射频能量传递和内镜合,代表了在门诊基础上管理慢性GORD的有希望的进步.
- 需要进一步进行经过良好控制的,随访时间较长的研究,以确认疗效,评估长期安全性,并评估与医疗管理相比的成本效益.
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