胃食道逆流性疾病:一个回顾
John Maret-Ouda1,2, Sheraz R Markar1,3, Jesper Lagergren1,4
1Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet, and Karolinska University Hospital, Stockholm, Sweden.
JAMA
|December 22, 2020
概括
胃食道反流症 (GERD) 影响20%的成年人,并可能导致严重的并发症. 治疗包括生活方式的改变,质子抑制剂 (PPI) 和手术,并有新兴的内镜选择.
科学领域:
- 胃肠病学
- 消化系统健康
背景情况:
- 胃食道逆流病 (GERD) 影响高收入国家大约20%的成年人,其特点是胃灼热和吐.
- GERD可以显著影响生活质量,增加食道并发症的风险,如巴雷特食道和腺癌.
- GERD的危险因素包括肥胖,吸烟和遗传,有时会出现消化不良和慢性咳等症状.
研究的目的:
- 审查GERD的临床治疗.
- 讨论目前和新兴的GERD治疗方案.
- 强调长期使用质子抑制剂 (PPI) 的重要性.
主要方法:
- 关于GERD诊断和治疗的文献综述
- 分析当前的治疗策略,包括改变生活方式,药物和手术.
- 评估新兴的内镜和微创手术技术.
主要成果:
- 典型的GERD症状通常允许用质子抑制剂 (PPI) 进行实证治疗.
- 对于没有反应或诊断不确定性的病例,建议进行内镜检查,测量和pH值监测.
- 生活方式的改变,PPI和腹腔镜膜是主要的治疗方法;新的内镜手术正在研究中.
结论:
- 有效的GERD管理至关重要,
- 质子抑制剂 (PPI) 治疗是主要的,但长期使用需要仔细的随访,因为潜在的不良反应.
- 新兴的内镜和手术技术为长期的PPI和传统手术提供了潜在的替代方案,尽管它们的长期疗效需要进一步研究.
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