Cooper J D, Jeejeebhoy K N
Ann Thorac Surg. 1981 Jun;31(6):577-93. doi: 10.1016/s0003-4975(10)61353-7.
The assessment of gastroesophageal reflux requires a carefully taken history and appropriate selection of the relevant diagnostic tests from among the many such tests available. Gastroesophageal reflux is generally produced by an imbalance between the intragastric pressure on the one hand and the degree of competence of the lower esophageal sphincter on the other. Medical management incorporates measures designed to promote gastric emptying, augment the resting tone of the lower esophageal sphincter, and favorably alter the nature of the refluxed material by dietary and pharmacological means. The surgical techniques commonly applied for the prevention of gastroesophageal reflux aim to restore an intraabdominal segment of esophagus and to augment sphincter competence by either a partial or complete fundoplication. Comparison of results obtained with various operations is difficult, as assessment is often imprecise, subjective, and partisan. Development of a uniform method of postoperative assessment, free from observed bias, would be a major advance.
胃食管反流的评估需要仔细采集病史，并从众多可用的相关诊断测试中适当选择。胃食管反流通常是由一方面的胃内压力与另一方面的食管下括约肌功能程度之间的失衡所引起的。药物治疗包括旨在促进胃排空、增强食管下括约肌静息张力以及通过饮食和药物手段有利地改变反流物质性质的措施。通常用于预防胃食管反流的手术技术旨在恢复食管的腹内段，并通过部分或完全胃底折叠术增强括约肌功能。由于评估往往不精确、主观且有偏见，因此比较各种手术获得的结果很困难。开发一种统一的、无观察偏差的术后评估方法将是一个重大进展。
