探讨高分辨率食管测压（HRM）联合24 h pH阻抗技术技术在胃食管反流病合并食管裂孔疝的诊断及腹腔镜胃底折叠术式选择。

回顾性分析2015年4月至2019年10月，潍坊市人民医院胃肠外科行胃镜及HRM检查联合24 h pH阻抗技术，确诊为胃食管反流病合并食管裂孔疝并收住普外科的167例患者的临床资料，统计胃镜及HRM检查联合24 h pH阻抗技术诊断胃食管反流病合并食管裂孔疝的确诊率。

HRM检查联合24 h pH阻抗技术的检出率为83.32%（139/167），特异性为100%（139/139）；胃镜确诊为67.06%（112/167）：其中由胃镜和HRM均确诊112例患者，约占80.57%（112/139），HRM技术的检出率明显高于胃镜；其中105例行腹腔镜治疗食管裂孔疝修补术联合胃底折叠术，7例患者及家属因各种原因放弃手术选择内科保守治疗。

HRM检查联合24 h pH阻抗技术较胃镜对胃食管反流病合并食管裂孔疝的诊断具有更高的特异性，并能够有效地指导胃底折叠手术方案。

0bjecfive To explore the clinical basis for the diagnosis of gastroesophageal reflux disease combined with hiatal hernia and the selection of laparoscopic fundus folding surgery by high-resolution esophageal manometer (HRM) combined with 24-hour pH impedance technique.

From April 2015 to October 2019,167 patients were diagnosed with gastroesophageal reflux disease combined with hiatal hernia and performed operations in Weifang people's hospital. The diagnosis rate of gastroesophageal reflux disease combined with hiatal hernia by gastroscopy and HRM combined with 24-hour pH impedance was calculated, and the status and role of gastroesophageal reflux disease combined with hiatal hernia in minimally invasive treatment of hiatal hernia were summarized.

The detection rate of HRM combined with 24-Hour pH impedance technique was 83.32% (139/167), and the specificity was 100% (139/139),and the confirmed by gastroscopy was 67.06% (112/167).Among them,112 patients were diagnosed by gastroscopy and HRM ,accounting for 80.57% (112/139).The detection rate of HRM combined with 24-Hour pH impedance technique was significantly higher than gastroscopy;105 cases were treated with laparoscopic esophageal hiatal hernia repair combined with gastric fundus folding ,and 7 patients gave up surgery to choose conservative treatment.

Compared with gastroscope, HRM examination combined with 24-hour pH impedance technique has higher specificity in the diagnosis of gastroesophageal reflux disease combined with hiatal hernia, and can effectively guide the gastric fundus folding operation..