CAJ | 학술논문

目的探讨腹腔镜胃底折叠术治疗胃食管反流病的临床效果。方法分析2008年1月至2014年6月，新疆医科大学第一附属医院收治的82例胃食管反流病行腹腔镜胃底折叠术患者的临床资料。9例行腹腔镜单纯胃底折叠术（ Toupet式），腹腔镜食管裂孔疝修补加胃底折叠术73例（ Nissen式9例，Toupet式64例）。结果手术均获成功，手术时间75～240 min、平均92 min，术中出血量5～200 ml ，平均14 ml ，均无输血。无术中中转开腹，无术后严重并发症，无死亡。腹腔引流管拔除时间1～3 d，平均2 d，术后住院时间4～10 d，平均7 d。82例术后随访1～24个月，平均15个月，64例临床症状完全消失，17例症状明显好转，1例无效。结论腹腔镜胃底折叠术是治疗胃食管反流病的有效方法，具有安全、有效、创伤小、患者恢复快和操作安全的优点，临床疗效满意。
목적탐토복강경위저절첩술치료위식관반류병적림상효과。방법분석2008년1월지2014년6월，신강의과대학제일부속의원수치적82례위식관반류병행복강경위저절첩술환자적림상자료。9례행복강경단순위저절첩술（ Toupet식），복강경식관렬공산수보가위저절첩술73례（ Nissen식9례，Toupet식64례）。결과수술균획성공，수술시간75～240 min、평균92 min，술중출혈량5～200 ml ，평균14 ml ，균무수혈。무술중중전개복，무술후엄중병발증，무사망。복강인류관발제시간1～3 d，평균2 d，술후주원시간4～10 d，평균7 d。82례술후수방1～24개월，평균15개월，64례림상증상완전소실，17례증상명현호전，1례무효。결론복강경위저절첩술시치료위식관반류병적유효방법，구유안전、유효、창상소、환자회복쾌화조작안전적우점，림상료효만의。
Objective To explore the clinical effect of laparoscopic fundoplication in the treatment of gastroesophageal reflux disease ( GERD ) .Methods Clinical data of patients with GERD in The First Affiliated Hospital of Xinjiang Medical University by laparoscopy was analyzed from January 2008 to June 2014.Among the patients,simple Toupt fundoplication was carried out in 9 cases,fundoplication combined with laparoscopic hiatal herniorraphy was performed on the other 73 cases ( Nissen in 9 and Toupet in 64 ) . Results All the patients had successfully completed operation , the operation time ranged from 75-240 minutes,with an average 92 minutes,the intraoperative blood loss was 5-200 ml,average was 14 ml,there was no blood transfusion ,no conversion to open surgery ,no severe postoperative complications and death .The time of drainage tube pulled out were 1-3 days,with average 2 days,postoperative hospitalization was 4-10 days, with average 7 days.82 patients were followed up for 1-24 months,with average 15 months,clinical symptoms disappeared completely in 64 cases and improved significantly in 17 cases, 1 case was invalid. Conclusion Laparoscopic fundoplication is effective in GERD and has the advantage of short hospital stay , good cosmetic result ,fast recovery and less complication .