高分辨率食管测压技术在腹腔镜治疗食管裂孔疝中的应用

doi:10.3877/cma.j.issn.1674-392X.2019.06.010

中华疝和腹壁外科杂志(电子版) ›› 2019, Vol. 13 ›› Issue (06) : 522 -524. doi: 10.3877/cma.j.issn.1674-392X.2019.06.010

所属专题：文献；

临床论著

高分辨率食管测压技术在腹腔镜治疗食管裂孔疝中的应用

杜亚君¹, 尚占民¹, 秦昌富²^,^†(

)

^1. 100043　首都医科大学附属北京朝阳医院西院消化内科
^2. 100043　首都医科大学附属北京朝阳医院疝和腹壁外科

收稿日期:2019-02-06 出版日期:2019-12-18
通信作者: 秦昌富
基金资助:
北京市医院管理中心"青苗"计划专项经费资助(QML20170307)

Application of high-resolution esophageal manometry in laparoscopic treatment of hiatal hernia

Yajun Du¹, Zhanmin Shang¹, changfu Qin²^,^†()

^1. Department of Gastroenterology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China
^2. Department of Hernia and Abdominal Wall Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100043, China

Received:2019-02-06 Published:2019-12-18
Corresponding author: changfu Qin
About author:
Corresponding author: Qin Changfu, Email: qin_pku2012@bjmu.edu.cn

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目的

探讨高分辨率食管测压（HRM）技术在腹腔镜治疗食管裂孔疝中的作用，为食管裂孔疝的诊断及手术提供临床依据。

方法

回顾性分析2016年4月至2018年10月，首都医科大学附属北京朝阳医院行胃镜及HRM检查，确诊为食管裂孔疝并收住疝和壁外科的67例患者的临床资料，计算胃镜及HRM检查食管裂孔疝的确诊率，分析手术情况，总结HRM技术在腹腔镜治疗食管裂孔疝手术中的地位及作用。

结果

HRM的检出率80.59%（54/67），特异性为100%（54/54）；胃镜确诊为52.24%（35/67）；其中由胃镜和HRM均确诊35例患者，约占64.81%（35/54），HRM技术的检出率明显高于胃镜；其中48例行腹腔镜治疗食管裂孔疝修补术治疗，7例患者及家属放弃手术选择内科保守治疗，12例合并其他基础疾病，保守或择期手术。

结论

HRM技术能够准确、直观的描述食管裂孔疝患者胃食管压力差，确诊率高，能够有效的指导手术方案。

关键词: 疝，食管裂孔, 腹腔镜, 胃底折叠术, 高分辨率食管测压技术

Objective

Investigating the role of high-resolution esophageal manometry in the treatment of esophageal hiatus hernia, and to provide a clinical basis for the diagnosis and operation of hiatal hernia.

Methods

From April 2016 to October 2018, 67 patients were diagnosed with esophageal hiatal hernia and performed with laparoscopic esophageal hiatus hernia repair in Beijing Chaoyang Hospital. The above data was analyzed to calculate the diagnosis rate of esophageal hiatal hernia by gastroscopy and high-resolution esophageal manometry, analyze the operation and summarize high-resolution esophageal manometry with high resolution manometry (HRM) technique in laparoscopic treatment of esophageal hiatal hernia.

Results

The detection rate of HRM was 80.59% (54/67), the specificity was 100% (54/54), and the confirmed by gastroscopy was 52.24% (35/67). Among them, 35 patients were diagnosed by gastroscopy and HRM, with 64.81% (35/54). The detection rate of high-resolution esophageal manometry was significantly higher than that of gastroscopy; 48 cases were treated with laparoscopic esophageal hiatal hernia repair, and 7 patients gave up surgery to choose conservative treatment. 12 patients complicated with other underlying diseases, took conservative treatment or elective surgery.

Conclusion

High-resolution esophageal manometry can accurately and intuitively describe the difference of gastroesophageal pressure in patients with hiatal hernia, and the diagnosis rate is high, which can effectively guide the surgical plan.

Key words: Hernia, hiatal, Laparoscopes, Fundoplication, High-resolution esophageal manometry

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