腹腔镜胃底折叠术治疗胃食管反流相关性高血压病临床研究

摘要

目的：观察胃食管反流病(gastroesophageal reflux disease, GERD)与高血压病的相关性以及腹腔镜胃底折叠术治疗胃食管反流相关性高血压病的效果。方法回顾性分析2011年6月—2012年6月我院18例行腹腔镜Nissen 胃底折叠术的 GERD 合并高血压病患者的临床资料。结果本组 GERD 病程(9.4±6.0)年,高血压病病程(5.2±6.0)年；13例以 GERD 症状首发,1~19年后合并高血压病,5例以高血压首发,0.8~10年后出现 GERD 症状。均手术成功,未发生气胸、食管破裂等术后严重并发症。本组术后12个月收缩压和舒张压均较术前下降(t =4.095, P =0．001；t =3.014,P =0．001),高血压病疗效：9例临床治愈,3例有效,6例无效。术后 Sc(疗效评价总积分)由术前18.50(14.25)分降至0(2.00)分(z =3.726,P =0．001),每例 Sc 均<12分,临床均治愈。结论 GERD 与部分高血压病密切相关,腹腔镜胃底折叠术治疗胃食管反流相关性高血压病安全、有效。%Objective To research the association between gastroesophageal reflux disease (GERD) and essential hypertension and the efficiency of laparoscopic Nissen fundoplication in the treatment of GERD-related hypertension. Methods We retrospectively analyzed the clinical data of 18 patients with essential hypertension undergoing laparoscopic fundoplica-tion for GERD between June 2011 and June 2012. Results 18 cases were diagnosed in compliance with GERD and hyperten-sion standard. The duration of GERD was (9. 4 ± 6. 0) years and the course of hypertension was (5. 2 ± 6. 0) years. The first symptoms were GERD symptoms in 13 cases and the complication of hypertension was found 1 to 19 years later. The first symptom was hypertension in 5 cases and the occurrence of GERD were from 0. 8 to 10 years later, indicating that the GERD was treated successfully. 1 year after the operation, the systolic blood pressure of these patients was decreased (t = 4. 095, P = 0. 001), and the diastolic blood pressure was decreased (t = 3. 014, P = 0. 001). Further more, the hypertension medi-cation was discontinued in 9 patients, the dose was reduced in 3 patients, and the medication was continued in 6 patients. The total score (Sc) decreased from 18. 50 (14. 25) preoperatively to 0 (2. 00) postoperatively (z = 3. 726, P = 0. 001). Con-clusion GERD is closely related to essential hypertension. Therefore, laparoscopic Nissen fundoplication is a safe and effec-tive way of treatment for patients with GERD-related hypertension.