腹腔镜下胃底折叠术（Nissen）对胃食管反流合并喉咽反流的影响

目的 初步探讨腹腔镜下Nissen手术对于胃食管反流（GERD）合并喉咽反流（LPR）患者的影响情况.方法 回顾性分析2006年8月至2011年7月收治并接受腹腔镜下Nissen手术的36例胃食管反流合并LPR患者,对其临床症状、手术方式、24hpH监测、频闪喉镜等资料进行归纳,与同期36例仅接受制酸剂治疗的患者做比较.结果 与单纯服药组患者相比,进行腹腔镜下Nissen手术患者术后喉咽部pH值、反流症状指标（RSI）、反流后果计分（RFS）、嗓音障碍指标（VHI）均有不同程度的改善（P＜0.05）.结论 腹腔镜下Nissen手术可有效控制LPR患者酸反流,改善喉咽局部的长期慢性刺激,在一定程度上抑制继发病变的产生.

Influence of laparoscopic nissen fundoplication on the laryngopharyngeal reflux

Objective To preliminarily study the influence of laparoscopic NISSEN fundoplication（LNF） on the patients who have gastroesophageal reflux disease （GERD）associated with laryngopharyngeal reflux （LPR）.Methods 36 patients in our department from 2006 to 2011 who have GERD associated with LPR and accepted NISSEN were reviewed and analyzed.To summarize the clinical symptoms,the operation means,the pH monitoring and stroboscopic laryngoscopy,then compared with 36 patients of the same period who only accepted antacids treatment.Results Compared with control group,the results showed LNF can improve the 24-hour postoperation oropharyngeal pH,Reflux Symptoms Index（RSI）,Reflux Finding Score（RFS） and the Voice Hindrance Index（VHI）in different degrees （P ＜ 0.05）.Conclusion LNF can control the acid reflux of patients who have LPR effectively,improve the long-term chronic stimulation of the regional laryngopharyngeal,and inhibit the generating of the secondary affection at a certain degree.