摘要
目的：探讨胃食管反流病（gastroesophageal reflux disease，GERD）临床表现和内镜下Stretta射频治疗效果。方法：对2006年4月-2007年2月施行内镜下射频治疗的200例GERD临床资料及随访情况进行分析。结果：200例中49例以反酸、烧心、咽部异物感等消化道症状为主；36例仅表现为咳嗽、咯痰、喘息、憋气等呼吸道症状；98例以消化道表现为主合并呼吸道症状；15例以呼吸道症状为主，偶有消化表道症状；2例现为胸骨后疼痛，诊为冠心病。治疗后即刻复查胃镜见190例贲门口包绕内镜紧密，10例贲门口较前缩紧；4例术中食管、贲门黏膜少量出血，无其他并发症。治疗2天内198例症状消失或明显缓解。随访1—11个月，5例自觉无明显改善，3例于术后1-7个月后复发（1例接受了重复治疗，“哮喘”再度消失），12例失访；180例（90．0％）症状消失或明显改善，以呼吸道症状为主者尤其明显。结论：GERD导致的呼吸道和咽喉部表现既常见凶险，又罕为大众所知，为此作者提出了以胃食管交接处为启动器、以咽为反应器、以口鼻为效应器、以喉气管为喘息发生器所引起的一系列临床表现，称为胃食管喉气管综合征（gastroesphago—larygotracheal syndrome，GELTS）或两管一腔综合征这一新概念。内镜下Stretta治疗GERD操作较为简捷、安全，具有颇好前号，更适于有严重呼吸道症状和GELTS的病例。复发时尚可重复治疗或改用手术治疗。
Objective：Exploring the clinical presentations and efficacy of the Stretta radiofrequency treatment under endoscope for patients with gastroesophageal reflux disease （GERD）. Methods： To analyze material of 200 patients with GERD who had been treated by Stretta radiofrequency. Results：49 patients with mainly acid reflux and heartburn;36 patients predominant had respiratory distresses,mostly diagnosed as asthma;98 had more digestive presentations and less＇ respiratory ones; 15 had more respiratory symptoms and less digestive ones ;2 patients misdiagnosed as coronary disease. The follow-up was from 1-11 months,5 patients felt no marked improvement;3 had recurrences 1-7 months after treatment （one among them had a redo resulted in an immediate disappearance of “asthma” ） ; 12 lost follow-up ; 180 patients had a disappearance of symptoms or a remarkable improvement, especially for those with respiratory distresses. Conclusion ：The respiratory and laryngopharynx presentations caused by GERD are not only common and risky,but also rarely known by public, the author thus raised a new concept of gastroesophago-laryngotracheal syndrome or GELTS or one cavity two tract syndrome, which is characteristic of gastroesophageal junction as the generator,pharynx the reactor,nose-oral cavity the effector,larynx and respiratory tract the asthmatic producer. The Stretta radiofrequency is a relatively simple,safe and none-invasive to treat patients with GERD,especially proper for those with respiratory distresses. If recurrence occurs ,the procedure can be repeated or other surgical procedures may also be installed.
出处
《临床误诊误治》
2007年第5期1-4,F0003,共5页
Clinical Misdiagnosis & Mistherapy
关键词
胃食管反流病
哮喘
胃食管喉气管综合征
两管一腔综合征
Stretta射频治疗
Gastroesophageal reflux disease
Asthma
Gastroesophago-laryngotracheal syndrome
Two track one cavity syndrome
Stretta radiofreguency
