CAJ | 학술논문

目的探讨食管裂孔疝(hiatal hernia,HH)与呼吸道症状相关性.方法 2009年1-12月在胃食管反流中心收集HH住院患者,分别对其性别、年龄、临床症状及诊治进行临床分析.结果在362例胃食管反流疾病(gastroesophageal reflux disease,GERD)患者中,196例有HH(54.1％),其中132例有呼吸道症状,64例无呼吸道症状,结果显示HH与呼吸道症状有相关性(x2=15.3,P=0).进一步多变量分析研究显示HH能增加呼吸道症状的风险(优势比OR值2.3,95％可信区间CI 1.5～3.6).196例HH患者中,178例行胃底折叠术并裂孔疝修补术,7例行胃底折叠术,11例保守治疗,术后168例疝修补术患者得到随访,平均随访(12±3)个月；7例胃底折叠术患者平均随访(12±4)个月,总有效率85.1％.结论 HH发病隐匿,由于其独特的形成因素,HH能增加反流及呼吸道症状的风险.通过有效的诊断并积极治疗HH,能显著减轻反流及其引起的呼吸道症状.
목적 탐토식관렬공산(hiatal hernia,HH)여호흡도증상상관성.방법 2009년1-12월재위식관반류중심수집HH주원환자,분별대기성별、년령、림상증상급진치진행림상분석.결과 재362례위식관반류질병(gastroesophageal reflux disease,GERD)환자중,196례유HH(54.1％),기중132례유호흡도증상,64례무호흡도증상,결과현시HH여호흡도증상유상관성(x2=15.3,P=0).진일보다변량분석연구현시HH능증가호흡도증상적풍험(우세비OR치2.3,95％가신구간CI 1.5～3.6).196례HH환자중,178례행위저절첩술병렬공산수보술,7례행위저절첩술,11례보수치료,술후168례산수보술환자득도수방,평균수방(12±3)개월；7례위저절첩술환자평균수방(12±4)개월,총유효솔85.1％.결론 HH발병은닉,유우기독특적형성인소,HH능증가반류급호흡도증상적풍험.통과유효적진단병적겁치료HH,능현저감경반류급기인기적호흡도증상.
Objective To observe the correlation between hiatal hernia(HH) and respiratory symptoms.Methods A retrospective data analysis was conducted using electronic medical records of HH patients suffering from gastroesophageal reflux disease (GERD) enrolled between January and December 2009.Clinical features including sex,age,symptoms,diagnosis,and treatment were analyzed.All the patients were requested to answer a questionnaire regarding the severity and frequency of symptoms to make an evaluating score for the follow-up.Results 362 cases of GERD patients were collected in the Center of Gastroesophageal Reflux Disease,196 cases had HH (54.1％),of which 132 cases with respiratory symptoms,64 cases without.All HH patients were analyzed,HH was correlated with respiratory symptoms (x2 =15.3,P =0).Multivariate analyses showed that HH could increase the risk of respiratory symptoms (odds ratio =2.3,95％ confidence interval 1.5-3.6).One hundred seventy-eight patients underwent fundoplication plus hernia repair,and 7 underwent fundoplication and 11 conservative treatment.In 168 hernia repair patients with an average follow-up of (12 ± 3) months,the result was excellent in 45 cases (26.8％),good in 63 cases (37.5％),fair in 35 cases (20.8％),and poor in 25 cases (14.9％).Seven cases of fundoplication patients followed up after (12 ± 4) months.One case was excellent,three were good and three were fair.The overall response rate was 85.7％.Conclusions HH usually has no significant clinical symptoms and difficult to diagnose.HH distinctively increases the risk of respiratory symptoms.Actively treating HH could ameliorate reflux symptoms,and control respiratory symptoms.