腹腔镜袖状胃切除联合食管裂孔疝修补术治疗肥胖合并阻塞性睡眠呼吸暂停综合征的近期疗效

目的:探讨腹腔镜袖状胃切除(LSG)联合食管裂孔疝修补术(HHR)治疗肥胖合并阻塞性睡眠呼吸暂停综合征(OSAS)的近期疗效。方法:回顾分析2018年3月至2019年5月接受LSG+HHR治疗的23例肥胖合并OSAS患者的临床资料。其中男11例,女12例,平均(38.13±11.84)岁,体质量指数平均(37.84±4.03)kg/m²;记录术前、术后6个月患者体重、BMI、胃食管反流病调查量表评分、24 h pH检测及呼吸暂停低通气指数、最低血氧饱和度等指标。采用配对t检验比较手术前后临床指标,采用Pearson相关性分析分析数据间的相关性。结果:术后6个月,患者体重由术前的(100.78±9.11)kg降至(80.74±7.74)kg;BMI由术前的(37.84±4.03)kg/m²降至(28.98±2.36)kg/m²;呼吸暂停低通气指数由术前的(34.04±13.8)降至(5.67±3.35);最低血氧饱和度由术前的(72.3±4.19)提至(85.97±5.27),OSAS轻度、中度、重度组胃食管反流病阳性率分别为33.33%(2/6)、37.5%(3/8)与66.67%(6/9),差异有统计学意义(P<0.05),患者体重、酸反流及睡眠呼吸相关指标均明显改善。结论:LSG+HHR治疗肥胖合并OSAS的效果较好,可达到抗反流、减重及改善OSAS等目的。     

产后不同程度的抑郁症状与胃食管反流病的相关性

目的探讨产后不同程度的抑郁症状与胃食管反流病的相关性。 方法自2018年8月至2019年3月在新疆维吾尔自治区人民医院妇产科门诊行产前检查，经住院分娩的初产妇82例设定为研究组。要求所有孕产妇均于产后2~8周进行焦虑自评量表（SAS）、抑郁自评量表（SDS）、爱丁堡产后抑郁自测量表（EPDS）以及GERD量表来调查分析产妇抑郁患病率及GERD相关症状的发生频率和严重程度。 结果孕期至产后2~8周的随访调查发现，孕期SDS和SAS问卷调查中出现的轻中重度抑郁焦虑者中，产后抑郁［EPDS（+）］患病率有所增加，这说明孕期有抑郁、焦虑等不良情绪的产妇产后抑郁症发病率相对较高。经SDS评分显示的EPDS（+）总例数21例产妇和EPDS（-）总例数61例产妇进行GERD症状评分分析，发现EPDS（+）组产妇GERD相关症状（反酸、烧心、胸骨后疼及睡眠障碍）的患病率均显著高于EPDS（-）组（P＜0.01）；产后抑郁（EPDS）评分相关性分析发现，反酸、烧心、胸骨后疼及睡眠障碍等GERD相关症状的发生频率与抑郁的严重程度呈正相关（P＜0.01）。 结论产后抑郁症患者GERD患病率较高，且随着抑郁严重程度其患病率逐渐增高。     

焦虑、抑郁及睡眠障碍与胃食管反流病的相关研究

ObjectiveTo analyze the mental abnormalities in patients with gastroesophageal reflux disease (GERD), and to explore the correlation between GERD and mental disorders. MethodsA total of 40 patients who diagnosed in our hospital from December 2017 to June 2018 were selected, then further divided into non erosive reflux disease (NERD) group and refluxive esophagitis (RE) group according to clinical manifestations, GERD questionnaire score and gastrointestinal endoscopy. Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Pittsburgh sleep quality index (PSQI) were used in two groups. ResultsAccording to the analysis result of HAMA in the two groups, the anxiety scale of NERD group was significantly higher than that of RE group (P＜0.05);HAMD analysis shows that depression scale in NERD group was significantly higher that RE group (P＜0.05); PSQI analysis shows that sleep disorder scale in NERD group was significantly higher that RE group (P＜0.05); the correlation analysis of GerdQ score showed that anxiety, depression and sleep disorder were positively correlated with the severity of symptoms (P＜0.05). ConclusionThe depression, anxiety and sleep disorder in NERD patients is higher than that in RE group. The scale of anxiety, depression and sleep disorder is helpful to the psychological intervention and the choice of rational drug treatment in GERD patients with mental disorders.