患有胃食道逆流但24小时pH值为负的患者的抗逆流手术:晚期结果
Midhun John1, Tanya Irvine2, Sarah K Thompson1
1Discipline of Surgery, College of Medicine and Public Health, Flinders University, South Australia, Australia.
概括
抗逆流体手术对患有胃食道逆流症症状的患者可能是有效的,即使24小时pH测试呈负值. 长期结果显示,各组的高满意度和低症状得分相似,支持在特定情况下进行手术.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 逆流性疾病管理管理
背景情况:
- 胃食道逆流性疾病 (GERD) 的诊断通常依赖于24小时的pH测试.
- 尽管有显著的反流症状,但可以出现负pH测试结果.
- 抗逆流体手术可以考虑仅仅基于症状,即使没有内镜性食道炎.
研究的目的:
- 为了确定抗逆流体手术的长期结果,在手术前的24小时pH测试结果为负的患者中.
- 为了比较pH测试结果为负的患者和测试结果为阳性的患者之间的结果.
- 根据在有症状的GERD患者的临床评估来评估手术的疗效.
主要方法:
- 一项针对745名接受抗逆流症手术的GERD患者的前性研究.
- 根据24小时pH值和内镜结果分组患者:阴性pH值/阴性内镜 (n=65),阴性pH值/阳性内镜 (n=72) 和阳性pH值 (n=608).
- 结果 (烧心,消化不良,满意度) 在5年后使用模拟分数进行评估.
主要成果:
- 在这三个组中,在5年随访后,胃灼热,消化不良或满意度得分没有显著差异.
- 负pH/负内镜组报告了高满意度 (平均8.13) 和低症状得分.
- 在所有组中,平均胃灼热得分一直很低 (1.80-1.91).
结论:
- 抗逆流体手术产生了相似的积极结果,无论手术前的24小时pH测试结果如何.
- 有症状的GERD患者经过阴性pH测试和阴性内镜检查,可以通过手术获得高满意度和症状缓解.
- 这些发现支持在经过精心挑选的有症状的GERD患者中考虑进行抗逆流体手术,这些患者的pH测试为负值.
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