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Nissen胃底折叠术治疗返流性食管炎获得了良好的效果,成功率达78～97%。本文从临床观察与内窥镜镜检查等方面评价了该手术后远期治疗效果。作者自1981～1987年对127例术前经食道镜检查证实的食管炎患者施行了Nissen胃底折叠术,2/3患者返流性食管炎病史>2年,且既往无食管、胃手术史。食管炎诊断依据:内窥镜显示Savary-Miller2～4期病变,或1期病变同时有组织病理学诊断,食道pH测定异常。127例中109例手术后平均77个月随诊,其中105例行食道镜检查以重新评价。73例术后无返流症状,内镜下见折叠壁良好;46例既无返流又无吞咽困难,19例暧气消失,44例出现呕吐困难,部分病人胃肠胀气
Nissen fundoplication for reflux esophagitis has achieved good results with a success rate of 78-97%. This article from the clinical observation and endoscopic examination and other aspects of the evaluation of the long-term postoperative treatment. Of the 127 patients who underwent esophagitis confirmed by esophagoscopy from 1981 to 1987, Nissen fundoplication was performed in 2 of 3 patients with a history of reflux esophagitis> 2 years and had no prior history of esophageal and gastric surgery . Esophagitis diagnosis based on: endoscopy showed Savary-Miller2 ~ 4 disease, or a disease with histopathological diagnosis, esophageal pH abnormalities. Of the 127 cases, 109 cases were followed up for an average of 77 months after operation, 105 of them were examined by esophagoscopy for re-evaluation. 73 patients had no postoperative reflux symptoms, endoscopic fold wall seen good; 46 cases of both no reflux and no difficulty swallowing, 19 cases of heating disappeared, 44 cases of vomiting difficulties, some patients with flatulence