Thal胃底折叠术治疗胃食管反流的疗效：中枢神经系统损伤的影响。

The efficacy of Thal fundoplication in the treatment of gastroesophageal reflux: the influence of central nervous system impairment.

作者信息

Tuggle D W, Tunell W P, Hoelzer D J, Smith E I

机构信息

Department of Surgery, University of Oklahoma College of Medicine, Oklahoma City.

出版信息

J Pediatr Surg. 1988 Jul;23(7):638-40. doi: 10.1016/s0022-3468(88)80635-3.

DOI:10.1016/s0022-3468(88)80635-3

PMID:3204462

Abstract

One hundred sixteen patients underwent a modified Thal fundoplication to correct gastroesophageal reflux (GER) between July 1, 1983, and January 30, 1987. Ninety-one percent of patients were relieved of GER. When patients were evaluated with respect to the presence or absence of CNS impairment there was a marked difference in the success rate of this procedure. Eight of 48 patients with CNS disorders had recurrent reflux with gastrostomy feedings after a modified Thal fundoplication (16%) while only two of 68 neurologically normal children had a failure of operation (3%; P less than .05). These data indicate that the modified Thal fundoplication is very effective in correcting GER in neurologically normal children but is less effective in children with CNS impairment.

摘要

1983年7月1日至1987年1月30日期间，116例患者接受了改良的Thal胃底折叠术以纠正胃食管反流（GER）。91%的患者GER症状得到缓解。当根据是否存在中枢神经系统（CNS）损害对患者进行评估时，该手术的成功率存在显著差异。48例患有CNS疾病的患者中，有8例在改良的Thal胃底折叠术后经胃造口喂养出现反流复发（16%），而68例神经功能正常的儿童中只有2例手术失败（3%；P<0.05）。这些数据表明，改良的Thal胃底折叠术在纠正神经功能正常儿童的GER方面非常有效，但在患有CNS损害的儿童中效果较差。