抗反流手术治疗胃食管反流病合并食管裂孔疝相关性顽固性呃逆的临床疗效

doi:10.3877/cma.j.issn.2095-8765.2024.02.005

中华胃食管反流病电子杂志 ›› 2024, Vol. 11 ›› Issue (02) : 91 -94. doi: 10.3877/cma.j.issn.2095-8765.2024.02.005

论著

抗反流手术治疗胃食管反流病合并食管裂孔疝相关性顽固性呃逆的临床疗效

李治仝¹, 胡珂琳², 刘冰熔³, 韩新巍³, 李晶晶¹, 张浩然¹, 张旭航¹^,^†(

), 季锋¹^,^†(

), 汪忠镐⁴

^1. 450052　郑州大学第一附属医院胃肠外科/疝和腹壁外科
^2. 999077　香港，香港珠海学院
^3. 450052　郑州大学第一附属医院消化内科
^4. 100053　北京，首都医科大学附属宣武医院血管外科

收稿日期:2024-02-16 出版日期:2024-05-15
通信作者: 张旭航, 季锋
基金资助:
中国科学院学部咨询评议项目(B-SM-2017-01)

Clinical efficacy of anti-reflux surgery in treatment of intractable hiccup due to gastroesophageal reflux disease with hiatus hernia

Zhitong Li¹, Kelin Hu², Bingrong Liu³, Jingjing Li¹, Haoran Zhang¹, Xuhang Zhang¹, Feng Ji¹^,^†(), Zhonggao Wang⁴^,^†()

^1. Department of Gastrointestinal surgery /Hernia and Abdominal Wall Surgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
^2. HONG KONG Chu Hai College, Hong kong 999077, China
^3. Gastroenterology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
^4. Department of Cardiovascular Surgery, Xuan Wu Hospital, Capital University of Medical Science, Beijing 100053, China

Received:2024-02-16 Published:2024-05-15
Corresponding author: Feng Ji, Zhonggao Wang

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引用本文：

李治仝, 胡珂琳, 刘冰熔, 韩新巍, 李晶晶, 张浩然, 张旭航, 季锋, 汪忠镐. 抗反流手术治疗胃食管反流病合并食管裂孔疝相关性顽固性呃逆的临床疗效[J]. 中华胃食管反流病电子杂志, 2024, 11(02): 91-94.

Zhitong Li, Kelin Hu, Bingrong Liu, Jingjing Li, Haoran Zhang, Xuhang Zhang, Feng Ji, Zhonggao Wang. Clinical efficacy of anti-reflux surgery in treatment of intractable hiccup due to gastroesophageal reflux disease with hiatus hernia[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2024, 11(02): 91-94.

目的

观察腹腔镜食管裂孔疝修补联合His角成形术对胃食管反流病合并食管裂孔疝相关性顽固性呃逆的治疗效果。

方法

收集2021年1月至2022年3月郑州大学第一附属医院收治的以顽固性呃逆为首发表现经腹腔镜食管裂孔疝修补联合His角成形术治疗的胃食管反流病合并食管裂孔疝的临床资料并行回顾性分析。

结果

本组10例患者均顺利完成手术，其中呃逆完全停止7例，呃逆频率或强度降低3例。2例腹胀明显时，呃逆易复发。治愈率70%，总有效率100%。术后胃镜、上消化道造影均未发现食管裂孔疝。

结论

胃食管反流病合并食管裂孔疝是顽固性呃逆的重要诱因，腹腔镜食管裂孔疝修补联合His角成形术治疗胃食管反流病合并食管裂孔疝相关性顽固性呃逆安全有效。

关键词: 胃食管反流病, 食管裂孔疝, 顽固性呃逆

Objective

To observe the clinical efficacy of laparoscopic hiatus hernia repair and angle of His reconstruction in treatment of intractable hiccup due to gastroesophageal reflux disease (GERD) with hiatus hernia (HH).

Methods

Analyzing our database of 10 patients with intractable hiccup who had laparoscopic HH repair and angle of His reconstruction for GERD plus HH.

Results

10 patients were successfully undergone laparoscopic surgery, with complete cessation of hiccup in 7 cases, reduction in frequency or intensity of hiccups in 3 cases. Hiccups were easy to recur when abdominal distension was obvious in 2 cases.The cure rate was 70%, and the total effective rate was 100%. HH was not found by gastroscopy or upper gastrointestinal angiography in all cases after surgery.

Conclusion

GERD plus HH were both important cause of intractable hiccup. The laparoscopic HH repair and angle of His reconstruction were safe and effective in the treatment of patients with intractable hiccup due to GERD or HH.

Key words: gastroesophageal reflux disease, Hiatus hernia, Intractable hiccup

表1 术前检查结果

反流性食管炎分级	例	食管裂孔疝（+）
反流性食管炎分级	例	胃镜（例）	UGBM（例）
G-C	7	6	7
G-D	3	3	3

表1 术前检查结果

反流性食管炎分级	例	食管裂孔疝（+）
反流性食管炎分级	例	胃镜（例）	UGBM（例）
G-C	7	6	7
G-D	3	3	3

表2 围手术期检查结果

反流性食管炎分级	例	食管裂孔疝（+）
反流性食管炎分级	例	胃镜	UGBM
G-o	9	0	0
G-A	1	0	0

表2 围手术期检查结果

反流性食管炎分级	例	食管裂孔疝（+）
反流性食管炎分级	例	胃镜	UGBM
G-o	9	0	0
G-A	1	0	0

1	Krakauer EL, Zhu AX, Bounds BC, et al. Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 6-2005. A 58-year-old man with esophageal cancer and nausea, vomiting, and intractable hiccups [J]. N Engl J Med, 2005, 352(8): 817-825.
2	Davenport J, Duong M, Lanoix R. Hiccup as the only symptom of non-ST-segment elevation myocardial infarction [J]. Am J Emerg Med, 2012, 30(1): 266-270.
3	Kolodzik PW, Eilers MA. Hiccups (singultus): review and approach to management [J]. Ann Emerg Med, 1991, 20: 565-273.
4	Lewis JH. Hiccups: causes and cures [J]. J Clin Gastroenterol, 1985, 7(6): 539-552.
5	Cymet TC. Retrospective analysis of hiccups in patients at a community hospital from 1995–2000 [J]. J Nat Med Assoc, 2002, 94(6): 480-483.
6	Jatoi A. Palliating hiccups in cancer patients: moving beyond recommendations from Leonard the lion [J]. J Support Oncol, 2009, 7(4): 129-130.
7	Wilcox SK, Garry A, Johnson MJ. Novel use of amantadine: to treat hiccups [J]. J Pain Symptom Manage, 2009, 38(3): 460-465.
8	Gyawali CP, Kahrilas PJ, Savarino E, et al. Modern diagnosis of GERD: the Lyon Consensus [J]. Gut, 2018, 67(7): 1351-1362.
9	Michael W, Gernot K, Stavros A, et al. Preoperative diagnosis of hiatal hernia: barium swallow X-ray, high-resolution manometry, or endoscopy? [J]. Eur Surg, 2017, 49(5): 210-217.
10	Frazzoni M, Piccoli M, Conigliaro R, et al. Laparoscopic fundoplication for gastroesophageal reflux disease [J]. World J Gastroenterol, 2014, 21, 20(39): 14272-14279.
11	Ma R, Li Y, Liu S, Zhao W. Acupuncture for cancer-related hiccups: Protocol for a systematic review and meta-analysis of randomized controlled trials [J]. Medicine (Baltimore), 2020, 99(20): e19973.
12	Federspil PA, Zenk J. Hiccup [J]. HNO, 1999, 47(10): 867-875.
13	Martínez Rey C, Villamil Cajoto I. Hiccup: review of 24 cases [J]. Rev Med Chile, 2007, 135(9): 1132-1138.
14	Haas C, Degoutte E, Biclet P, et al. Intractable hiccup caused by hiatal hernia with esophagitis [J]. Presse Med, 1989, 18(12): 634.
15	Sfara A, Dumitrascu DL. The management of hiatal hernia: an update on diagnosis and treatment [J]. Med Pharm Rep, 2019, 92(4): 321-325.
16	Zhang R, Li Z, Li C, et al. Effect of laparoscopic angle of His reconstruction in the treatment of patients with gastroesophageal reflflux disease and hiatal hernia [J]. Chin Med J (Engl), 2022, 135(14): 1750-1752.

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