中华消化病与影像杂志（电子版）
中華消化病與影像雜誌（電子版）
중화소화병여영상잡지（전자판）
2014年
2期
66-69
,共4页
李建东%赵法云%王磊%边振光%左振球%王奎玲
李建東%趙法雲%王磊%邊振光%左振毬%王奎玲
리건동%조법운%왕뢰%변진광%좌진구%왕규령
疝,食管裂孔%胃镜检查%食管pH监测%食管压力%聚桂醇%黏膜下注药
疝,食管裂孔%胃鏡檢查%食管pH鑑測%食管壓力%聚桂醇%黏膜下註藥
산,식관렬공%위경검사%식관pH감측%식관압력%취계순%점막하주약
Hernia,esophageal hiatus%Gastroscopy%Esophageal pH monitoring%Esophageal pressure%Lauromacrogol%Submucous injection
目的：探讨聚桂醇在食管裂孔疝（ HH）治疗中的疗效。方法选取HH患者69例，常规进镜至胃腔，退镜至食管膈裂孔压迹处，通过内镜活检孔插入注射针，在食管膈裂孔压迹处、齿状线处及LES区环周分别多点注射聚桂醇，点间隔1 cm，总量小于10 ml，每周一次，4次为一个疗程。疗程结束后1个月再次测定食管pH值、食管压力并胃镜检查，比较注药前后患者的食管pH值、食管压力指数、内镜下黏膜改变及临床症状改善情况。结果注药后1个月的食管pH值、食管压力及齿状线与膈食管裂孔压迹的距离与注药前比较，差异有统计学意义（ P＜0.05）。注药后反流性食管炎内镜分级提高、临床症状明显改善。结论聚桂醇注射于LES区及膈裂孔区可改善食管内酸性环境，降低酸暴露时间，提高食管下段括约肌的压力，可在短时间内有效的改善临床症状，提高非手术治疗者的生存质量。
目的：探討聚桂醇在食管裂孔疝（ HH）治療中的療效。方法選取HH患者69例，常規進鏡至胃腔，退鏡至食管膈裂孔壓跡處，通過內鏡活檢孔插入註射針，在食管膈裂孔壓跡處、齒狀線處及LES區環週分彆多點註射聚桂醇，點間隔1 cm，總量小于10 ml，每週一次，4次為一箇療程。療程結束後1箇月再次測定食管pH值、食管壓力併胃鏡檢查，比較註藥前後患者的食管pH值、食管壓力指數、內鏡下黏膜改變及臨床癥狀改善情況。結果註藥後1箇月的食管pH值、食管壓力及齒狀線與膈食管裂孔壓跡的距離與註藥前比較，差異有統計學意義（ P＜0.05）。註藥後反流性食管炎內鏡分級提高、臨床癥狀明顯改善。結論聚桂醇註射于LES區及膈裂孔區可改善食管內痠性環境，降低痠暴露時間，提高食管下段括約肌的壓力，可在短時間內有效的改善臨床癥狀，提高非手術治療者的生存質量。
목적：탐토취계순재식관렬공산（ HH）치료중적료효。방법선취HH환자69례，상규진경지위강，퇴경지식관격렬공압적처，통과내경활검공삽입주사침，재식관격렬공압적처、치상선처급LES구배주분별다점주사취계순，점간격1 cm，총량소우10 ml，매주일차，4차위일개료정。료정결속후1개월재차측정식관pH치、식관압력병위경검사，비교주약전후환자적식관pH치、식관압력지수、내경하점막개변급림상증상개선정황。결과주약후1개월적식관pH치、식관압력급치상선여격식관렬공압적적거리여주약전비교，차이유통계학의의（ P＜0.05）。주약후반류성식관염내경분급제고、림상증상명현개선。결론취계순주사우LES구급격렬공구가개선식관내산성배경，강저산폭로시간，제고식관하단괄약기적압력，가재단시간내유효적개선림상증상，제고비수술치료자적생존질량。
Objective To evaluate the efficacy of endoscopic submucous injection of lauromacrogol in the treatment of hiatal hernia .Methods A total of 69 patients with hiatal hernia were enrolled in the study.After gastroscope was drawn back to the esophageal diaphragmatic hiatus , multi-point submucosal injection of lauromacrogol was performed in the esophageal diaphragmatic hiatus , pectinate line and LES circumferential area once a week .There were four times in a course of treatment .The interval of injection point was 1cm and the total dose of lauromacrogol was less than 10ml.One month after the course of treatment,esophageal pH, esophageal pressure, endoscopic mucosal changes and clinical symptoms were compared with those before injection .Results There were significant differences in terms of esophageal pH , esophageal pressure and the length between pectinate line and diaphragmatic esophageal hiatus before and after administration of lauromacrogol (P<0.05).After injection,endoscopic grade of reflux esophagitis and clinical symptoms were improved significantly .Conclusions Endoscopic injection of lauromacrogol can improve the acidic environment ,reduce acid exposure time and increase lower esophageal sphincter pressure . Therefore,it is effective to improve the clinical symptoms and the life quality of non-surgical patients with hiatal hernia in a short period .
