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腹腔镜Dor 胃底折叠术治疗合并焦虑和(或)抑郁状态的反流性食管炎患者的远期疗效
李大勇,吴瑜,王帅,曹占国
国家卫生健康委员会激素与发育重点实验室 天津医科大学、天津市代谢性疾病重点实验室、天津医科大学朱宪彝纪念医院& 天津市内分泌研究所天津 300134;天津市南开医院胃肠外科三天津 300100
摘要:
目的:评价腹腔镜Dor 胃底折叠术(LDF) 治疗合并焦虑和(或)抑郁状态的反流性食管炎(RE)患者的远期疗效。方法:选取2009 年12 月—2012 年7 月我科收治的RE 患者51 例,其中合并焦虑和(或)抑郁状态(观察组)19 例,单纯RE(对照组,32 例),均采用LDF 进行治疗,比较两组治疗前后的Demeester 评分、食管LES 静息压、GERD-Q 评分、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、满意度评分及复发情况。结果:两组患者均成功行LDF,术后早期症状均获得有效缓解,两者患者的GERD-Q 和Demeester 评分均低于术前,食管LES 静息压均高于术前,差异有统计学意义(P <0.01);观察组术后SAS、SDS 评分低于术前,差异有统计学意义(P <0.05),对照组术前术后的SAS、SDS 评分差异无统计学意义。术后长期随访结果,观察组反流症状复发率高于对照组,满意度评分低于对照组,差异有统计学意义(P <0.05)。结论:LDF 治疗合并焦虑和(或)抑郁状态的RE 安全且有效,但远期反流症状复发率高于对照组。提示对合并焦虑和(或)抑郁状态的RE 患者应加强术后抗焦虑治疗,以巩固疗效。
关键词:  腹腔镜(Dor)胃底折叠术  反流性食管炎  焦虑和(或)抑郁状态
DOI:10.3969/j.issn.1007-6948.2020.05.028
投稿时间:2020-04-21
基金项目:
Long Term Effect of Laparoscopic DorFundoplication in the Treatment of Reflux Esophagitis with Anxiety and/or Depression
LI Da-yong,WU Yu,WANG Shuai
Abstract:
Objective To compare the long-term follow-up results of laparoscopic dor fundoplication (LDF) in patients with reflux esophagitis (RE) complicated with anxiety and/or depression in the control group, and to evaluate the long-term effect of this method. Methods 19 patients with anxiety and/or depression who had LDF from December 2009 to July 2012 were analyzed retrospectively. Compared with 32 patients in the same period of the control group, they were followed up for 7.1-9.5 years, with an average of 8.9±0.7 years. The long-term treatment effects of the two groups were analyzed. Results LDF was successfully performed in both groups and the early symptoms were effectively relieved after operation. The long-term follow-up results showed that the recurrence rate of symptoms in the observation group was higher than that in the control group, and the satisfaction score was lower than that in the control group, which the difference was statistically significant (P <0.05). Conclusion LDF is safe and effective in the treatment of RE patients with anxiety and/ordepression, but the recurrence rate of reflux symptoms in the long term is higher than that in the control group.
Key words:  Laparoscopic dor fundoplication  reflux esophagitis  anxiety and/or depression

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