探究腹腔镜下食管裂孔疝修补术中应用Bougie管（36F）对减少及预防术后吞咽功能障碍的效果。

选取2023年6月至2024年1月在新疆维吾尔自治区人民医院微创、疝与腹壁外科接受同一术者食管裂孔疝修补联合抗反流手术的40例胃食管反流病合并食管裂孔疝患者作为研究对象。随机分为腹腔镜食管裂孔疝修补+Nissen胃底折叠术组（非支撑管组，20例）和36F Bougie管支撑下腹腔镜食管裂孔疝修补+Nissen胃底折叠术组（支撑管组，20例）。采用χ²检验比较2组患者术后1周、1个月、3个月吞咽功能评定的差异，采用t检验比较2组术前、术后1周、1个月、3个月胃食管反流病问卷（GERD-Q）评分的差异以及术后与术前的差异。

术后1周，非支撑管组有5例患者出现了轻度吞咽功能障碍，2例患者出现中度吞咽功能障碍，而支撑管组仅1例患者出现轻度吞咽功能障碍，2组差异具有统计学意义（χ²=8.633，P=0.013）。术后1个月，支撑管组GERD-Q评分高于非支撑管组[（5.30±0.65）分vs （5.15±1.18）分]，差异具有统计学意义（t=-0.496，P=0.011），术后1周和3个月2组评分比较，差异无统计学意义（P>0.05）。组内比较发现，非支撑管组术后1周、1个月、3个月的GERD-Q评分与术前比较[（7.25±0.85）分vs （5.15±1.18）分vs （4.85±0.87）分vs （11.95±1.39）分]，差异均具有统计学意义（P均<0.001）。支撑管组术后1周、1个月、3个月的GERD-Q评分与术前比较[（6.90±1.02）分vs （5.30±0.65）分vs （4.65±0.58）分vs （11.90±1.48）分]，差异均具有统计学意义（P均<0.001）。

食管裂孔疝修补术联合胃底折叠术术中采用36F Bougie支撑管可在保证抗反流效果的同时有效减少术后吞咽功能障碍的发生。

To investigate the effectiveness of using a 36F Bougie tube during laparoscopic hiatal hernia repair in reducing and preventing postoperative dysphagia and swallowing dysfunction.

A total of 40 patients with gastroesophageal reflux disease combined with hiatal hernia who underwent hiatal hernia repair combined with anti-reflux surgery at the Department of Minimally Invasive, Hernia and Abdominal Wall Surgery of the Xinjiang Uygur Autonomous Region People’s Hospital between June 2023 and January 2024 were enrolled. They were randomly divided into two groups: the laparoscopic hiatal hernia repair plus Nissen fundoplication group without the support tube (20 cases) and the laparoscopic hiatal hernia repair plus Nissen fundoplication group with the support of a 36F Bougie tube (20 cases). The χ² test was used to compare differences in swallowing function evaluations between the two groups at 1 week, 1 month, and 3 months postoperatively, while the t-test was employed to compare the differences in Gastroesophageal Reflux Disease Questionnaire (GERD-Q) scores between the two groups preoperatively and at 1 week, 1 month, and 3 months postoperatively, as well as the differences between postoperative and preoperative scores.

At 1 week postoperatively, 5 patients in the non-support tube group experienced mild dysphagia and 2 patients experienced moderate dysphagia, whereas in the support tube group, only 1 patient experienced mild dysphagia. This difference was statistically significant (χ²=8.633, P=0.013). At 1 month postoperatively, the GERD-Q score in the support tube group was higher than that in the non-support tube group [(5.30±0.65) points vs (5.15±1.18) points], and this difference was statistically significant (t=-0.496, P=0.011). However, comparisons between the two groups at 1 week and 3 months postoperatively showed no statistically significant differences (P>0.05). Within-group comparisons revealed that the GERD-Q scores in the non-support tube group at 1 week (7.25±0.85), 1 month (5.15±1.18), and 3 months (4.85±0.87) postoperatively differed significantly from the preoperative score (11.95±1.39, P<0.001). Similarly, the GERD-Q scores in the support tube group at 1 week (6.90±1.02), 1 month (5.30±0.65), and 3 months (4.65±0.58) postoperatively also differed significantly from the preoperative score (11.90±1.48, P<0.001).

The use of a 36F Bougie support tube during hiatal hernia repair combined with Nissen fundoplication effectively reduces the incidence of postoperative swallowing dysfunction while ensuring an adequate anti-reflux effect.