- 期刊
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食道裂孔疝氣－不容忽視的老年人疾病
Hiatal Hernia: A disease of the Elderly
摘要
背景：橫膈食道裂孔疝氣是指橫膈膜上食道通過的孔道肌肉退化，導致胃或腹部器官向胸腔推擠。常造成老年人食慾下降、體重減輕；嚴重者有心律不整與呼吸困難等危及生命之症狀。目的：探討食道裂孔疝氣類型、臨床表徵與手術預後。方法：採用病歷回溯方式，調查南部某區域醫院，自2009年6月至2019年11月接受食道裂孔疝氣修補術之個案。結果：共有25位病患接受腹腔鏡輔助剖腹執行食道裂孔疝氣修補，分類以第三型居多有15（60%）位，平均住院天數7.4（±5.1）天。術前以胃酸逆流的症狀為最常見有17位（68%）；術後追蹤約三個月後，嘔吐（p ＜.000）、胃灼熱感（p =.005）、上腹痛（p =.008）以及胃酸逆流（p ＜.000）等症狀皆達顯著改善。結論：腹腔鏡輔助剖腹執行食道裂孔疝氣修補，術後住院時間短，病患的生活品質大幅改善且術後三個月內無裂孔疝氣的復發。
並列摘要
Background: Hiatal hernia (HH) refers to the degeneration of the cruse muscle around the esophagus through the diaphragm, which causes the stomach or abdominal organs to push into the thoracic cavity. It often causes poor appetite and weight loss in the elderly; severe cases even have life-threatening symptoms such as arrhythmia and respiratory distress. Objective: To evaluate the types, clinical manifestations and prognosis of hiatal hernia after laparoscopy-assisted repair of hiatal hernia. Methods: A retrospective study was conducted from June 2009 to November 2019 through medical records to investigate the surgical results of hiatal hernia in a regional hospital of southern Taiwan. Results: A total of 25 patients underwent surgical repair of hiatal hernia, of which 15 (60%) were classified as type III HH. The average hospital stay was 7.4 (±5.1) days. Preoperatively, gastroesophageal reflux symptoms were the most common in 17 patients (68%). Upon postoperative follow-up after more than three months, the symptoms including vomiting (p ＜ .000), heartburn (p = .005), epigastric pain (p = .008), and gastroesophageal reflux (p ＜ .000) were significantly improved. Conclusion: Laparoscopy-assisted laparotomy to perform repair of hiatal hernia can shorten postoperative hospitalization. In a 3-month follow-up period, the patients' quality of life was greatly improved, and there was no recurrence of hiatal hernia within three months after surgery.