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中华肥胖与代谢病电子杂志 ›› 2024, Vol. 10 ›› Issue (03) : 184 -192. doi: 10.3877/cma.j.issn.2095-9605.2024.03.005

青年专家论坛

肥胖与胃食管反流病的关系及减重术后反流治疗研究进展
郭明杰, 周春起, 余佳慧, 李世红, 朱红梅, 刘雁军, 杨华武()   
  1. 646099 四川省泸州市,西南医科大学临床医学院;610031 成都,成都市第三人民医院胃肠微创中心·肥胖与代谢性疾病中心
    646099 四川省泸州市,西南医科大学临床医学院
    610031 成都,成都市第三人民医院胃肠微创中心·肥胖与代谢性疾病中心
  • 收稿日期:2024-03-11 出版日期:2024-08-30
  • 通信作者: 杨华武
  • 基金资助:
    四川科技厅项目(No.22efgjmg)

Relationship between obesity and gastroesophageal reflux disease and research progress on reflux treatment after bariatric surgery

Mingjie Guo, Chunqi Zhou, Jiahui Yu, Shihong Li, Hongmei Zhu, Yanjun Liu, Huawu Yang()   

  1. School of Clinical Medicine, Southwest Medical University, Luzhou 646099, Sichuan, China; Chengdu Third People's Hospital Gastrointestinal Minimally Invasive, Center Obesity and Metabolic Disease Center, Chengdu 610031, China
    School of Clinical Medicine, Southwest Medical University, Luzhou 646099, Sichuan, China
    Chengdu Third People's Hospital Gastrointestinal Minimally Invasive, Center Obesity and Metabolic Disease Center, Chengdu 610031, China
  • Received:2024-03-11 Published:2024-08-30
  • Corresponding author: Huawu Yang
引用本文:

郭明杰, 周春起, 余佳慧, 李世红, 朱红梅, 刘雁军, 杨华武. 肥胖与胃食管反流病的关系及减重术后反流治疗研究进展[J]. 中华肥胖与代谢病电子杂志, 2024, 10(03): 184-192.

Mingjie Guo, Chunqi Zhou, Jiahui Yu, Shihong Li, Hongmei Zhu, Yanjun Liu, Huawu Yang. Relationship between obesity and gastroesophageal reflux disease and research progress on reflux treatment after bariatric surgery[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2024, 10(03): 184-192.

当前肥胖合并胃食管反流病(GERD)的患者数量逐渐增多,且肥胖患者行减重术后GERD的发生率也有增加。这可能与食管括约肌破坏,胃内压升高,消化道解剖结构破坏等多种因素有关。本文对肥胖与胃食管反流的关系、相关的发病机制以及治疗方法进行了阐述,重点对减重术后胃食管反流的治疗方式进行了总结,以期为肥胖合并胃食管反流的患者提供更安全、有效的治疗方法。

The prevalence of both obesity and gastroesophageal reflux disease (GERD) is steadily increasing. Notably, the incidence of GERD in patients with obesity undergoing bariatric surgery is also on the rise. This could be attributed to factors such as esophageal sphincter dysfunction, elevated gastric pressure, and alterations in digestive tract anatomy following surgery. This paper aims to investigate the link between obesity and GERD, focusing on the underlying mechanisms and the challenges of treating GERD after bariatric surgery. The primary objective is to explore effective and safe treatment strategies for managing reflux in patients post-bariatric surgery.

图1 常见减重手术术式注:A为腹腔镜袖状胃切除术(LSG);B为腹腔镜Roux-en-Y胃旁路术(LRYGB);C为腹腔镜单吻合口胃旁路术(OAGB)
图2 Stretta系统示意图注:A为内镜引导下到达胃食管连接处;B为球囊膨胀使电极刺入食管肌层;C为通过射频消融的能量使黏膜下纤维化和固有肌层增厚;D为内镜检查食管内径缩窄,增加LES的压力
图3 经口内镜下贲门重建术示意图
图4 腹腔镜袖状胃切除术联合胃底折叠术注:A为腹腔镜袖状胃切除术联合Nissen手术;B为腹腔镜袖状胃切除术联合Toupet手术;C为腹腔镜袖状胃切除术联合Dor手术
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