Therapeutic effect of improved ARMS on treatment of refractory gastroesophageal reflux disease and its influence on inflammatory indicators and postoperative complications
Objective This paper attempts to explore the therapeutic effect of improved endoscopic anti reflux mucosal resection(ARMS)on refractory gastroesophageal reflux disease(RGERD)and its impact on inflammatory indicators and postoperative complications.Methods A total of 60 patients with RGERD admitted to Zhoushan Hospital from January 2021 to June 2022 were selected as the study subjects who were divided into an experimental group and a control group using a random number table method,with 30 cases in each group.The experimental group received improved ARMS treatment,while the control group received ARMS treatment.The surgical related indicators of the two groups were recorded,and the clinical efficacy and the results of gastroduodenoscopy were evaluated based on the clinical symptoms of patients after treatment.The throat reflux symptom index(RSI)and Anderson dysphagia inventory(MDADI)were used to evaluate the pharyngeal reflux and swallowing condition.The levels of C-reactive protein(CRP),IL-6,and white blood cell count(WBC)were compared between the two groups.Gastroscopy was performed before and 6 months after surgery,and the gastroesophageal valve was graded by Hill.The quality of life of the subjects was evaluated using the gastroesophageal reflux disease health related quality of life scale(GERD-HRQL).Follow-up of the subjects after surgery was conducted using outpatient and telephone methods,and the postoperative complications were compared between the two groups.Results The total effective rate of treatment in the experimental group is 93.33%,higher than that in the control group(83.33%),but the difference is not statistically significant(P＞0.05).Compared with the control group,the experimental group has a longer operation time,a lower RSI index at 1 month and 6 months after surgery,a higher MDADI score,and lower serum CRP,IL-6 and WBC levels at 1 week and 2 weeks after surgery,with statistically significant differences(P＜0.05).Compared with the preoperative results,the Hill grading of gastroesophageal valve flap in the two groups decrease at 6 months after surgery,with statistically significant differences(P＜0.05).The proportion of Hill grade Ⅰ in the experimental group is 46.67%,which is higher than that in the control group(30.00%),but the difference is not statistically significant(P＞0.05).Compared with the control group,the GERD-HRQL scores of the experimental group at 1 month and 6 months after surgery are lower,with statistically significant differences(P＜0.05).All the subjects in the two groups successfully completed the surgical treatment,with no death cases,only 2 cases of dysphagia in the control group,and a 6.67%incidence of postoperative complications.Conclusions The effect of improved ARMS on the treatment of RGERD is accurately definite,which can effectively alleviate postoperative inflammatory stress response,reduce pharyngeal reflux and incidence of postoperative dysphagia,and thus improve the quality of life of patients.It has clinical promotion value.
维普
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