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目的:探讨肠系膜上动脉综合征(SMAS)所致胃食管反流(GER)性咳喘的诊治方法。方法:回顾性分析6例SMAS致GER性咳喘患者的临床资料。结果:患者的临床表现主要为上腹间断性胀痛、反酸、烧心、咳嗽、哮喘等,上消化道造影示十二指肠水平段受压。2例行保守治疗,4例行手术治疗。随访1.5~84个月,3例术后症状改善明显,1例术后并发胃瘫,予胃动力药物治疗后缓解;2例保守治疗,症状得到有效控制,但需长期服质子泵抑制剂及胃动力药物。结论:SMAS致GER性咳喘的诊治需兼顾SMAS和GER,手术与保守治疗相结合可获满意疗效。
Objective: To investigate the diagnosis and treatment of gastroesophageal reflux (GER) cough and asthma caused by superior mesenteric artery syndrome (SMAS). Methods: The clinical data of 6 patients with GER caused by SMAS were retrospectively analyzed. Results: The main clinical manifestations of patients with abdominal intermittent abdominal pain, acid reflux, heartburn, cough, asthma, upper gastrointestinal angiography shows the level of duodenal compression. 2 routine conservative treatment, 4 cases of surgical treatment. Follow-up 1.5 ~ 84 months, 3 cases of postoperative symptoms improved significantly, 1 case of postoperative gastroparesis, gastric motility drug treatment to ease; 2 cases of conservative treatment, the symptoms are effectively controlled, but protracted proton pump inhibitor and Gastric drug. Conclusion: The diagnosis and treatment of GER caused by SMAS need both SMAS and GER. The combination of surgery and conservative treatment can achieve satisfactory results.