腹腔镜胃底折叠术治疗合并焦虑和（或）抑郁的胃食管反流病

目的：探讨腹腔镜胃底折叠术治疗合并焦虑和（或）抑郁的胃食管反流病（ GERD）的疗效。方法收集2012年3月至9月以消化道症状为主的胃食管反流病患者86例，根据焦虑和抑郁自评量表（ SAS/SDS）将患者分为两组：A组为单纯GERD组，B组为合并焦虑和（或）抑郁的GERD患者。所有患者均行腹腔镜下胃底折叠术（ LF）治疗，术后6个月对患者进行电话随访，分析比较两组反流症状缓解以及B组患者精神心理改善情况。使用SPSS 18．0软件进行统计分析，同一患者术前术后数据采用配对t检验；组间正态数据采用t检验，非正态数据采用秩和检验。 P＜0．05为差异有统计学意义。结果术后6个月，A组和B组GERD症状评分分别显著下降了（89．6±19．7）％和（68．3±27．8）％（ta ＝9．97， Pa ＜0．001；tb＝5．47， Pb ＜0．001），A组症状缓解率更显著（P＝0．019）。B组SAS评分由（52．78±4．83）显著降至（40．59±9．69）（t＝7．12， P＜0．001）；SDS评分由（57．70±6．29）显著降至（39．57±5．62）（t＝8．74， P＜0．001）。结论手术治疗对于合并或不合并精神症状的两组患者的反流症状均有效，同时还可改善部分患者的焦虑和抑郁评分；明显的焦虑和抑郁可以负面影响手术效果。

Laparoscopy fundoplication in treating gastroesophageal reflux disease combined with anxiety and/or depression

Objective To explore the curative effect of laparoscopy fundoplication （LF） in treatinggastroesophageal reflux disease （GERD） combined with anxiety and /or depression.Methods 86 patientswere diagnosed with GERD from March to September in 2012.Assessed by using the self-rating anxiety scale（SAS） and self-rating depression scale （SDS）, 86 patients were divided into two groups ： GERD patientswithout psychological disorder （group A） and GERD patients accompanied with psychological disorder （groupB）.LF was performed in all the patients, and follow-up was done by questionnaires 6 months after surgery tocompare the clinical outcomes of GERD symptoms and the relief in psychological status between the 2groups.The data were analyzed using SPSS version 18.0 software, including self-control study using pairedStudent’s t test, Measurement data were compared in normal distribution between the two groups usingStudent’s t test, but non-normal variables by the rank-sum test.A P value 〈0.05 was considered asstatistically significant.Results Six months after surgery, the GERD symptom score significantly decreasedin group A（89.6 ±19.7）% and group B（68.3 ±27.8）% （ta =9.97, Pa 〈0.001; tb =5.47, Pb 〈0.001respectively）, but there was a reduction of rates in group A with significant difference （P =0.019）.TheSAS score of group B was significantly reduced from （52.78 ±4.83） to （40.59 ±9.69） （t =7.12, P 〈0.001）, while SDS score was also significantly reduced from （57.70 ±6.29） to （39.57 ±5.62） （t =8.74, P 〈0.001）.Conclusions LF treatment is effective for GERD patients with or without psychologicaldisorder, but with reduced anxiety and /or depression scores.In the other hand, anxiety and/or depressionshowed negative impact on the relief of GERD symptoms after LF treatment .