中国胃食管反流病的诊疗进展

doi:10.3877/cma.j.issn.2095-8765.2024.02.002

胃食管反流病（GERD）是常见的慢性消化系统疾病。在中国，GERD的患病率高达8.7%。由于GERD临床表现多样化，其诊断对于临床医师是一大挑战。中国指南提出洛杉矶B级及以上食管炎或食管酸暴露百分比超过4%可确诊GERD。另外，尽管抑酸药物是GERD的一线治疗方式，但仍有高达50%的患者服药后症状无法有效缓解。药物治疗无效的患者通常选择接受内镜下抗反流手术，但是一部分患者术后仍需服用抗反流药物甚至接受二次手术以控制GERD症状。本文总结了目前中国GERD的诊断和治疗现状，为临床医师提供一定参考。

关键词: 胃食管反流病, 诊断, 治疗

Gastroesophageal reflux disease (GERD) is one of the most common chronic gastrointestinal disorders. The prevalence of GERD in China is 8.7%. Due to the diverse manifestations, the diagnosis of GERD is a challenge for clinicians. Chinese guideline proposed that patients with Los Angeles grade B/C/D esophagitis or acid exposure time>4% could be diagnosed as GERD. Although acid suppressive therapy is the first-line treatment for GERD, up to 50% of patients did not report effective symptom relief despite medications. Such patients typically undergo endoscopic anti-reflux surgery, but some still need to take anti-reflux medication or even undergo a secondary surgery to control GERD symptoms. This article summarized the current status of diagnosis and treatment of GERD in China, offering valuable insights for clinical physicians.

Key words: Gastroesophageal reflux disease, Diagnosis, Treatment

图1 中国典型或不典型GERD症状患者GERD诊断流程注：GERD为胃食管反流病

图2 中国食管外症状患者GERD诊断流程注：GERD为胃食管反流病

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