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食管裂孔疝病例约有半数没有症状;有症状者多数可用药物缓解,仅有5%患者因伴有严重并发症而手术。有症状的裂孔疝,多数由于下端食道括约肌功能不全而伴有胃食道反流。在过去15年中,作者曾为上述病例作了400次手术。本文目的在于复习胃食道反流的并发症、诊断、手术指征、操作及其治疗结果。[症状和体征]胸骨下烧灼感:为反流性食管炎的典型症状,约占90%;常伴口内反流酸味,多见于饱食后或平卧时。
About half of esophageal hiatal hernia cases have no symptoms; the majority of symptomatic patients can be relieved with drugs, and only 5% of patients with severe complications due to surgery. Symptomatic hiatal hernia, mostly due to lower esophageal sphincter insufficiency accompanied by gastroesophageal reflux. In the past 15 years, the author has performed 400 surgeries for these cases. This article aims to review the gastroesophageal reflux complications, diagnosis, surgical indications, operation and treatment results. [Symptoms and signs] Sternal burning sensation: a typical symptom of reflux esophagitis, accounting for about 90%; often accompanied by oral reflux acidity, more common after satiation or supine.