腹手术前GERD查:与手术前EGD发现相比,GERD-HRQL问卷得分的预测价值
Jonathan Allotey1, Michael Caposole1, Abdallah Attia1
1Division of Bariatric and MIS, Department of Surgery, Tulane University, School of Medicine, New Orleans, LA, USA.
Surgical endoscopy
|September 21, 2023
概括
胃食道逆流性疾病 (GERD) 患者报告的症状不能在减肥手术候选人中可靠地预测食道炎. 建议进行常规的手术前食管胃管腺镜检查 (EGD),以进行准确的评估和程序选择.
科学领域:
- 腹部外科 腹部外科
- 胃肠病学 胃肠病学
- 手术患者的查
背景情况:
- 关于确定胃食道逆流症 (GERD) 胃食道逆流病 (GERD) 在腹腔外科手术前的最佳方法存在争论.
- 患者报告的症状和常规的手术前食道胃管腺镜 (EGD) 是常见的查工具,但它们的价值仍在争论中.
研究的目的:
- 评估患者报告的症状之间的相关性,使用验证的问卷和腹部手术候选人的手术前EGD发现.
- 为了确定食道炎和缺口的GERD症状的预测值.
主要方法:
- 对200名接受减肥手术的患者进行前性队列研究.
- 患者在手术前完成了与GERD相关的健康生活质量 (GERD-HRQL) 调查问卷.
- 强制性手术前EGD进行;患者根据症状得分分层 (0=无症状,>0=有症状).
- 统计分析包括皮尔森的千二测试,威尔科克森的等级和和测试,以及接收器运行特征 (ROC) 曲线分析.
主要成果:
- 在症状和无症状组之间,食道炎或椎间的发病率没有显著差异.
- GERD-HRQL总,仅烧胃和仅排泄的得分是食道炎的不良预测指标 (AUCs ~0.52).
- 在无症状患者中,较高的BMI与食管炎有关 (OR 1.15,p=0.002).
结论:
- 患者报告的GERD症状是食道炎或其严重程度的不可靠指标,在腹腔外科手术前的人群中.
- 推对所有腹腔外科手术前的患者进行自由查上部内镜 (EGD).
- 在指导适当程序选择和管理GERD方面,EGD至关重要.
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