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内镜下抗反流黏膜切除术(Stretta射频消融术)治疗胃食管反流病的临床疗效:一项回顾性单中心队列研究。

Clinical efficacy of endoscopic antireflux mucosectomy . Stretta radiofrequency in the treatment of gastroesophageal reflux disease: a retrospective, single-center cohort study.

作者信息

Sui Xinke, Gao Xiaopei, Zhang Lu, Zhang Bin, Zhong Changqing, Chen Yan, Wang Xiaoying, Li Dou, Wu Wei, Li Lianyong

机构信息

Department of Gastroenterology, Strategic Support Force Medical Center, Beijing, China.

Department of Otorhinolaryngology Head and Neck Surgery, Strategic Support Force Medical Center, Beijing, China.

出版信息

Ann Transl Med. 2022 Jun;10(12):660. doi: 10.21037/atm-22-2071.

Abstract

BACKGROUND

Currently, antireflux mucosectomy (ARMS) and Stretta radiofrequency (SRF) are the most commonly used minimally invasive antireflux therapies. To date, there have not been any reports comparing ARMS and SRF. Our aim was to compare the clinical efficacies of these two therapeutic methods.

METHODS

We analyzed data from gastroesophageal reflux disease (GERD) patients, including 39 who received ARMS treatment and 30 who received SRF treatment between January 2020 and May 2021. Symptom control, gastroesophageal reflux disease questionnaire (GERDQ) score, gastroesophageal reflux disease health-related quality of life (GERD-HRQL) score, proton pump inhibitor (PPI) withdrawal, and PPI reduction were analyzed and compared.

RESULTS

After 6 months of follow-up, the results showed that both therapies were effective in improving symptoms and quality of life. No difference was found between the ARMS group and SRF group in GERDQ score, GERD-HRQL score, PPI withdrawal rate, or PPI reduction rate (P>0.05). There was no significant difference in the PPI withdrawal rate between the two therapies among patients with gastroesophageal flap valve (GEFV) grade II and grade III (P>0.05), but the PPI withdrawal rate in the ARMS group was significantly higher than that in the SRF group among patients with GEFV grade IV (P<0.05).

CONCLUSIONS

The clinical efficacies of ARMS and SRF 6 months postoperation were equivalent. The results showed that both ARMS and SRF treatment were acceptable for patients with GEFV grades II and III, while ARMS should be selected for patients with GEFV grade IV.

摘要

背景

目前,抗反流黏膜切除术(ARMS)和Stretta射频术(SRF)是最常用的微创抗反流治疗方法。迄今为止,尚无比较ARMS和SRF的报道。我们的目的是比较这两种治疗方法的临床疗效。

方法

我们分析了胃食管反流病(GERD)患者的数据,包括2020年1月至2021年5月期间接受ARMS治疗的39例患者和接受SRF治疗的30例患者。分析并比较了症状控制、胃食管反流病问卷(GERDQ)评分、胃食管反流病健康相关生活质量(GERD-HRQL)评分、质子泵抑制剂(PPI)停用情况和PPI减量情况。

结果

随访6个月后,结果显示两种治疗方法均能有效改善症状和生活质量。ARMS组和SRF组在GERDQ评分、GERD-HRQL评分、PPI停用率或PPI减量率方面均无差异(P>0.05)。在胃食管瓣(GEFV)II级和III级患者中,两种治疗方法的PPI停用率无显著差异(P>0.05),但在GEFV IV级患者中,ARMS组的PPI停用率显著高于SRF组(P<0.05)。

结论

术后6个月ARMS和SRF的临床疗效相当。结果表明,GEFV II级和III级患者接受ARMS和SRF治疗均可,而GEFV IV级患者应选择ARMS治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f599/9279761/392c0ac5d09a/atm-10-12-660-f1.jpg

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