腹腔镜食管裂孔疝修补术联合胃底折叠术对胃食管反流病合并食管裂孔疝患者抗反流效果及生活质量的影响

目的探讨腹腔镜食管裂孔疝修补术联合胃底折叠术对胃食管反流病（gastroesophageal reflux disease，GERD）合并食管裂孔疝（hiatus hernia，HH）患者抗反流效果及生活质量的影响。 方法选取新疆维吾尔自治区人民医院消化科住院部自2015年3月至2017年8月收治的78例GERD合并HH患者为研究对象，分为2组。观察组行腹腔镜HH修补术联合胃底折叠术（42例），对照组行传统开腹术（36例）。随访观察2组患者手术情况、不良反应发生情况以及RDQ和GLQI评分。 结果观察组患者术中出血量和手术时间、术后住院时间、胃肠道功能恢复时间均低于对照组，差异有统计学意义（P<0.05）。术后3及6个月随访中，观察组的RDQ评分低于对照组，GLQI评分高于对照组（P<0.05），差异均有统计学意义（P<0.05）。观察组术后不良反应发生率为7.14%，对照组术后不良反应发生率为16.67%，但2组差异无统计学意义（P>0.05）。 结论对于GERD合并HH患者，采用腹腔镜HH修补术联合胃底折叠术的手术方案，手术情况及抗反流效果更好，患者生活质量更高。

Effect of anti-reflux effect and quality of life in patients with gastroesophageal reflux disease complicated with hiatal hernia using laparoscopic hiatal hernia repair combined with fundoplication

ObjectiveTo investigate the effect of anti-reflux effect and quality of life in patients with gastroesophageal reflux disease (GERD) complicated with hiatal hernia (HH) using laparoscopic hiatal hernia repair combined with fundoplication. Methods78 patients with gastroesophageal reflux disease complicated with hiatal hernia in the inpatient department of the digestive department from Xinjiang Uygur Municipal People's hospital from March 2015 to August 2017 were selected and divided into the observation group (42 cases) with laparoscopic hiatal hernia repair combined with fundoplication and the control group (36 cases) with traditional laparotomy. The operation status, postoperative adverse reactions, RDQ and GLQI scores were selected and compared between two groups. ResultsThe blood loss during the operation, the time of the operation, hospital-staying time and recovery time of intestinal function in in the observation group were lower than those in the control group, with statistical significance between the two groups (P<0.05). The RDQ scores in the observation group was lower than that in the control group, while the GLQI score was higher than that in the control group, with statistical significance between the two groups (P<0.05). However, there was no statistical difference in the adverse reactions between the two groups (P>0.05). ConclusionLaparoscopic hiatal hernia repair combined with fundoplication is a better method for patients with gastroesophageal reflux disease complicated with hiatal hernia, with better anti-reflux effect and better quality of life, which is worthy for further clinical application.