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GERD的内镜治疗方法现有3类:第1类是于贲门部造成皱襞的ELGP法,全层缝合术和内镜下缝合术;第2类是将LES区肌层变性的Stretta法;第3类是于LES区插入异物的Enteryx法和Gatekeeper法。从疗效来看,在改善症状和酸反流上采用任一方法均适宜,多可取得PPI停药率约70%的疗效。从临床实用的手技、有效性与安全性而言,以ELGP法、全层缝合术和Stretta法为优。对于今后研发新疗法在内的一切治疗技术,均宜从近期与远期效果、安全性、手技简便化以及费用和患者的愿望等观点考虑,并进行科学验证,进而达到优存劣汰。
There are three types of endoscopic treatments for GERD: the first is the ELGP, folds and endoscopic suture in the cardia; the second is the Stretta method of degeneration of the myometrium in the LES; the second Category 3 is the Enteryx method and Gatekeeper method that insert foreign material in the LES area. From the efficacy point of view, in the improvement of symptoms and acid reflux using either method are appropriate, and can get PPI withdrawal rate of about 70% of the effect. From the clinical practical skills, effectiveness and safety, the ELGP method, full-thickness suture and Stretta method is excellent. All treatment technologies for future research and development of new therapies should be scientifically validated from the viewpoints of short-term and long-term effects, safety, simplification of hand techniques, costs and patients’ wishes, so as to achieve the survival of the fittest and the survival of the fittest.