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目的依据非酸反流对胃食管反流病类型之一的糜烂性食管炎(EE)患者抑酸治疗后食管内镜影像的改变,分析并评价非酸反流对抑酸治疗EE的影响。方法选择2013年1月至2014年12月门诊治疗的59例非酸反流EE患者作为研究对象。采用质子泵抑制剂(埃索美拉唑镁肠溶片)联合巴氯芬片、多潘立酮片及胃黏膜保护药(复方海藻酸片),进行抑酸治疗,治疗前、后对患者进行24 h食管p H连续监测,统计24 h内p H<4的总时间百分率、24 h p H值、24 h p H<4的阳性率。根据反流性食管炎标准进行分级,比较食管内镜影像的变化及食管病变分级比例。结果非酸反流EE患者抑酸治疗后24 h内p H<4的总时间百分率、24 h p H值、24 h p H<4的阳性率与治疗前比较,差异均有统计学意义(P<0.05,P<0.01)。治疗前食管损伤有糜烂并呈非全周性融合;治疗后糜烂面吸收,局部融合创面愈合。非酸EE患者治疗后食管内镜影像的食管病变程度分级较治疗前明显好转(P<0.01)。结论胃食管反流病临床治疗效果判定主要依据患者临床症状的改善,食管内镜影像阳性率是重要的评价标准。
Objective To analyze and evaluate the effect of non-acid reflux on acid suppression in patients with esophageal edema (EE) based on the changes of esophageal endoscopy after acid-elimination in patients with erosive esophagitis (EE), a type of gastroesophageal reflux disease. Methods Fifty-nine patients with non-acid refluxing EE from January 2013 to December 2014 were enrolled in this study. Proton pump inhibitors (esomeprazole magnesium enteric-coated tablets) combined with baclofen tablets, domperidone tablets and gastric mucosal protective drugs (compound alginate tablets), acid suppression therapy before and after treatment of patients with 24 h Esophageal p H was continuously monitored. The total time percentage of p H <4 within 24 h, the 24 hp H value, and the positive rate of 24 hp H <4 were calculated. According to reflux esophagitis standard grading, esophageal endoscopic image changes and esophageal lesions grading ratio. Results The positive rate of p H <4 in 24 h after acid suppression therapy in non-acid reflux patients was significantly higher than that before treatment (P < 0.05, P <0.01). Ectopic esophageal injury before treatment and non-full-fledged fusion erosion; absorption after treatment, local fusion wound healing. Esophageal endoscopic esophageal lesion grade in non-acid EE patients was significantly improved after treatment (P <0.01). Conclusion The clinical evaluation of gastroesophageal reflux disease is mainly based on the improvement of clinical symptoms. The positive rate of endoscopic esophagoscopy is an important evaluation criterion.