中国实用外科杂志

中国实用外科杂志

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腹腔镜Hill修补术治疗胃食管反流病20例疗效分析

王    斌，张    伟，刘    晟，姚    钰，仇    明   

  1. 海军军医大学第二附属医院普外三科，上海 200003
  • 发布日期:2020-07-23

  • Published:2020-07-23

摘要： 目的    探讨腹腔镜Hill修补术治疗胃食管反流病的临床价值。方法    回顾性分析2019年1-10月海军军医大学第二附属医院普外三科收治的行经腹腔镜Hill修补术治疗的20例GERD病人的临床资料，随访观察临床疗效。结果    术中测压提示Hill修补缝合后LESP显著高于缝合前水平（t=42.845，P<0.001）。20例病人术后6周复查，反流症状均明显改善，胃食管交界区阀瓣形态均较为良好，24 h食管pH监测无一例出现异常酸反流。Hill修补术后平均下食管括约肌静息压为（29.4±1.90）mmHg，显著高于术前平均水平（t=37.014，P<0.001）。结论    腹腔镜Hill手术可提高下食管括约肌静息压及重建胃食管交界区阀瓣结构，对GERD病人抗反流效果显著。

关键词: 胃食管反流病, Hill手术, 阀瓣瓣膜结构, 下食管括约肌静息压

Abstract: Effect of laparoscopic Hill repair for gastroesophageal reflux disease: An analysis of 20 cases        WANG Bin，ZHANG Wei，LIU Sheng，et al. No. 3 Department of General Surgery，Changzheng Hospital，Naval Medical University，Shanghai 200003，China
Corresponding author：QIU Ming，E-mail：qium127@smmu.edu.cn
Abstract    Objective    To evaluate the clinical effect of laparoscopic Hill repair for gastroesophageal reflux disease. Methods    The clinical data of 20 patients underwent laparoscopic Hill repair in No. 3 Department of General Surgery，Changzheng Hospital，Naval Medical University from January 2019 to October 2019 were analyzed retrospectively and the therapeutic effect was followed up and studied. Results    Intraoperative manometry showed that the lower esophageal sphincter pressure following Hill suture was significantly higher than the preoperative level (t=42.845，P<0.001). At 6 weeks after surgery，all of the twenty patients had improved symptoms of reflux. The shape of valve flap in the gastroesophageal junction area was good under gastroscope. None of the twenty patients was diagnosed as abnormal acid reflux in 24 hours esophageal pH monitoring. The mean postoperative lower esophageal sphincter pressure was (29.4 ± 1.90) mmHg，which was significantly higher than that before operation (t=37.014，P<0.001). Conclusion    Laparoscopic Hill repair can increase the lower esophageal sphincter pressure and reconstruct the valve flap structure of the gastroesophageal junction area，which has a significant clinical effect in the treatment of gastroesophageal reflux disease.

Key words: gastroesophageal reflux disease, Hill repair, valve flap structure, lower esophageal sphincter pressure