胃食管反流病诊断和治疗的指南

《胃食管反流病诊断和治疗的指南》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、胃食管反流病诊断和治疗的最新指南录入时间:2009-1-1213:43:43UpdatedGuidelinesfortheDiagnosisandTreatmentofGastroesophagealRefluxDisease胃食管反流病诊断和治疗的最新指南Theseguidelinesareapplicabletoadultpatientswithsymptoms,tissuedamage,orboththeresultfromtherefluxofgastriccontentintotheesoph

2、agus,forthepurposeoftheseguidelines,GERDisdefinedassymptomsormucosaldamageproducedbytheabnormalrefluxofgastriccontentsintoesophagus.本指南适用于由于胃内容物反流到食管导致的症状或（和）黏膜损害的成年病人，为了运用木指南，GERD的定义是指胃内容物异常反流进入食管产生的症状或黏膜损害。DiagnosisguidelineI:EmpiricaltherapyIfthepatie

3、nt'shistoryistypicalforuncomplicatedGERD,aninitialtrialofempiricaltherapy(includinglifestylemodification)isappropriate.Endoscopyatpresentationshouldconsideredinpatientswhohavesymptomssuggestingcomplicateddisease.thoseatriskforBarrettesophagus，whenthepati

4、entandphysicianfeelearlyendoscopytobeappropriate.诊断指南1:经验性治疗如果病人表现为典型的、无并发症的胃食管反流病，首先给予包描改变生活方式在内的试验性治疗是恰当的。对于症状提示有并发症、存在巴雷特食管危险者、或当病人和内科医生认为早期内镜检查是适当的时候，应考虑行内镜检查。DiagnosisguidelineII:UseofendoscopyinGERDEndoscopyisthetechniqueofchoiceusedtoidentifysuspe

5、ctedBarrett'sesophagusandtodiagnosecomplicationofGERD.BiopsymustbeaddedtoconfirmthepresenceofBarrett'sepitheliumandevaluatefordysplasiao诊断指南II：内镜检查在GERD中的应用内镜检查技术用于怀疑存在巴雷特食管的检查和诊断GERD的并发症，必须进行活组织检查以证实Barrett?s上皮的存在和评估异型增生。DiagnosisguidelineIII:Ambulatory

6、RefluxmonitoringAmbulatorymonitoringoftheesophagushelptoconfirmgastroesophagealrefluxinpatientswithpersistentsymptoms(bothtypicalandatypical)withoutevidenceofmucosaldamage,especiallywhenatrialofacidsuppressionhasfailed.Itmayalsobeusedtomonitorthecontrolo

7、frefluxinpatientswithcontinuedsymptomsontherapy.诊断指南in：动态反流监测食管动态反流监测有助于证实在有持续性症状(典型或非典型的)而无黏膜损伤证据的病人存在胃食管反流，特别是当试验性抑酸治疗失败时。也可用于监测在治疗时症状仍持续存在病人的反流控制情况。DiagnosisguidelineIV:EsophagealmanometryEsophagealmanometrymaybeusedtoensureaccurateplacementofambulato

8、rymonitoringprobesandmaybehelpfulpriortoantirefluxsurgery.诊断指南IV：食管测压法食管测压法口J用于动态反流监测探头的精确定位和抗反流手术的术前食管功能评估。TreatmentguidelineI:LifestylemoditlcationLifestylemodificationmaybenefitmanypatientswithGERD，althoughthesechangesa