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腹腔镜下尼氏胃底折叠术在治疗与胃食管反流病相关的慢性咳嗽患者方面比斯特雷塔射频治疗更有效。

Laparoscopic Nissen fundoplication is more effective in treating patients with GERD-related chronic cough than Stretta radiofrequency.

作者信息

Liang W T, Wu J M, Hu Z W, Wang Z G, Zhu G C, Zhang C

机构信息

Department of Thoracic Cardiovascular Surgery Xuanwu Hospital, Capital Medical University No. 45 Changchun Street, Xicheng District, Beijing, P.R. China -

出版信息

Minerva Chir. 2014 Jun;69(3):121-7. Epub 2014 May 14.

Abstract

AIM

Chronic cough is the most common extra-esophageal manifestation of gastroesophageal reflux disease (GERD). This study aimed to retrospectively analyze outcomes in patients with GERD-related cough following laparoscopic Nissen fundoplication (LNF) and Stretta radiofrequency (RF) respectively.

METHODS

Medical charts of 83 patients with GERD-related cough that underwent LNF or Stretta RF between 2007 and 2012 were retrieved. Symptom scores (heartburn, regurgitation and cough) and proton pump inhibitors (PPIs) usages were evaluated.

RESULTS

A total of 83 patients with GERD-related cough underwent LNF (N.=35) and Stretta RF (N.=48), and were followed up 36.78 ± 16.12 months (range 13-55 months). During the follow-up, the post-treatment scores were statistically lower as compared with the pre-treatment scores in both groups, while the cough improvement after Stretta was significantly lower than that after LNF (P<0.001). Besides, 27 (77.1%) patients achieved complete PPI therapy independence after LNF, comparing with 27 (65.1%) after Stretta (P<0.05). No significant differences in post-treatment complications were observed except for the abdominal distention.

CONCLUSION

Even though laparoscopic Nissen fundoplication and Stretta are capable of controlling GERD-related cough effectively and safely in selected patients, laparoscopic Nissen fundoplication could improve more in symptoms and PPI elimination.

摘要

目的

慢性咳嗽是胃食管反流病(GERD)最常见的食管外表现。本研究旨在分别回顾性分析腹腔镜nissen胃底折叠术(LNF)和Stretta射频消融术(RF)治疗GERD相关性咳嗽患者的疗效。

方法

检索2007年至2012年间83例接受LNF或Stretta RF治疗的GERD相关性咳嗽患者的病历。评估症状评分(烧心、反流和咳嗽)和质子泵抑制剂(PPI)的使用情况。

结果

共有83例GERD相关性咳嗽患者接受了LNF(n = 35)和Stretta RF(n = 48)治疗,并随访36.78±16.12个月(范围13 - 55个月)。随访期间,两组治疗后的评分均显著低于治疗前,而Stretta术后咳嗽改善程度显著低于LNF术后(P < 0.001)。此外,LNF术后27例(77.1%)患者实现了完全停用PPI治疗,而Stretta术后为27例(65.1%)(P < 0.05)。除腹胀外,治疗后并发症无显著差异。

结论

尽管腹腔镜nissen胃底折叠术和Stretta射频消融术能够在部分患者中有效且安全地控制GERD相关性咳嗽,但腹腔镜nissen胃底折叠术在症状改善和停用PPI方面效果更佳。

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