Cohen S
Postgrad Med. 1975 Jan;57(1):97-102. doi: 10.1080/00325481.1975.11713946.
Gastroesophageal reflux is not synonymous with sliding hiatus hernia. It should be approached as a condition dependent on the intrinsic strength of the lower esophageal sphincter rather than on the presence of a hiatus hernia. The patient's account of symptoms is probably the most important means of diagnosis, but in addition the patient's history should be supplemented by radiographic evaluation. Initially the treatment of gastroesophageal reflux is one of prevention. If this conservative approach proves ineffective, drugs that restore sphincter strength can be tried. Surgery should be resorted to only if medical treatment fails, and then one of the newer specific antireflux procedures should be the operation of choice.
胃食管反流并非滑动型食管裂孔疝的同义词。应将其视为一种取决于食管下括约肌内在强度而非食管裂孔疝存在与否的病症。患者对症状的描述可能是最重要的诊断手段，但此外，患者的病史还应以影像学评估作为补充。最初，胃食管反流的治疗是预防性治疗之一。如果这种保守方法证明无效，可以尝试使用恢复括约肌强度的药物。只有在药物治疗失败时才应采取手术治疗，届时较新的特定抗反流手术应作为首选手术。
