Ianova O B, Vasnev O S
Ter Arkh. 2011;83(4):36-9.
To study informative value of 24-h pH monitoring in registration of gastroesophageal and duodenogastroesophageal reflux (GER, DGER) in patients with gastroesophageal reflux disease (GERD) before and after surgical treatment.
A total of 39 GERD patients after laparoscopic fundoplication entered the study: 12 (39%) males and 27 (61%) females, mean age 47.6 +/- 3.2 years. pH monitoring was made with domestic device Gastroscan-24 before operation and one year after it. Esophagogastroscopy and polypositional roentgenoscopy of the upper gastroduodenal tract were made also before operation and after 1-year follow-up.
Before operation, mean pH in the gastric body was 1.7 +/- 1.28, De Meester index 40.4 +/- 8.91, esophageal acidity index (EAI) 22.3 +/- 1.59, the number of acid GER 59.2 +/- 9.41, number of DGER 14.3 +/- 3.47. After laparoscopic fundoplication--3.3 +/- 1.52, 8.7 +/- 5.71 (p < 0.05), 2.5 +/- 0.62 (p < 0.05), 24.4 +/- 8.6 (p < 0.05), 6.5 +/- 3.63, respectively. Five patients (12.8%) examined before the operation had clinicoendoscopic picture of GERD, but normal values of De Meester index and EAI.
24-h pH monitoring can estimate both gastroesophageal and duodenoesophagogastric refluxes, but esophageal and gastric pH monitoring only are not sufficient for decision on treatment policy. Such decision should be taken individually for each patient after the analysis of the results of complete clinical examination, symptoms and the disease history.
研究24小时pH监测在胃食管反流病（GERD）患者手术治疗前后胃食管反流（GER）及十二指肠胃食管反流（DGER）记录中的信息价值。
共有39例接受腹腔镜胃底折叠术的GERD患者纳入研究：男性12例（39%），女性27例（61%），平均年龄47.6±3.2岁。术前及术后1年使用国产Gastroscan - 24设备进行pH监测。术前及1年随访后还进行了食管胃镜检查及上消化道多体位X线透视检查。
术前，胃体平均pH值为1.7±1.28，De Meester指数为40.4±8.91，食管酸度指数（EAI）为22.3±1.59，酸性GER次数为59.2±9.41，DGER次数为14.3±3.47。腹腔镜胃底折叠术后分别为3.3±1.52、8.7±5.71（p<0.05）、2.5±0.62（p<0.05）、24.4±8.6（p<0.05）、6.5±3.63。术前检查的5例患者（12.8%）有GERD的临床内镜表现，但De Meester指数和EAI值正常。
24小时pH监测可评估胃食管反流和十二指肠胃食管反流，但仅进行食管和胃的pH监测不足以决定治疗策略。应在对每位患者的完整临床检查、症状和病史结果进行分析后，为其个体化制定治疗决策。
