胃氣脹痛和胃酸倒流 檢查及治療 - thevoice.org.hk · 餐後 酸液體倒流 ......
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胃氣脹痛和胃酸倒流 胃氣脹痛和胃酸倒流 檢 檢 查 查 及治療 及治療 蕭永泰醫生 蕭永泰醫生 外科專科醫生 外科專科醫生 養和醫院外科中心 養和醫院外科中心 名譽顧問 名譽顧問
Transcript of 胃氣脹痛和胃酸倒流 檢查及治療 - thevoice.org.hk · 餐後 酸液體倒流 ......
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5500
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(~60%)
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> 3
-
?
,
/
(Barretts oesophagus)
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/
, ,
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1-3
-
(PPI)
(pH)
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Barrett Barrett / /
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0102030405060708090
GERD Non-GERDLZP (60mg) Placebo
Endoscopic negative patientstreated for 5 days
Percentage of Patients Positive
1R Fass et al Arch Intern Med 1999;159(2):2161-21682P Juul-Hansen Sand J Gastroenterol 2001;36(8):806-10
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NERD
-
(pH)
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A
sthm
a pa
tient
s ex
perie
ncin
g G
ERD
sy
mpt
oms
(%)
100
80
60
40
20
0
7772
65
Perrin-Fayolle et al. (n=150)
OConnell et al.(n=189)
Field et al. (n=109)
Harding & Sontag, Am J Gastroenterol 2000; 95(Suppl): S2332.
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Asthmatic patients with GORD (n=118)Wheezing or
shortness of breath 65
98Cough
60Chest pain
83Heartburn
87Regurgitation
91Nausea
0 20 40 60 80 100Respiratory and oesophageal symptoms associated with
oesophageal acid events (%)
Harding et al., Chest 1999; 115: 6549.
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H2
Hatlebakk & Berstad, Clin Pharmacokinet 1996; 31: 386406.
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(
)
(
)
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Tricyclics
-
H2
Hatlebakk & Berstad, Clin Pharmacokinet 1996; 31: 386406.
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44--8 weeks8 weeks (PPI)
4 weeks4 weeks (PPI)
H2
-
100
80
%)
60
ays
(
40urn-
free
d
20Hea
rtb
0
Lansoprazole 30 mg once daily
First 3 days First week First 2 weeks Entire 8 weeks
n=3510 patients with erosive GORD diagnosed by endoscopy randomised to study
Richter et al., Am J Gastroenterol 2001; 96: 308998.
-
: vsH2
90
80
70
60
50
40
30
20
10
0
Bardhan, Res Clin Forum 1998; 20: 2732.
Cum
ulat
ive
rela
pse
at 1
yea
r (%
) 78
62
25
Lansoprazole15 mg
Placebo Ranitidine300600 mg
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(Barrettsoesophagus),
0.9-2%
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/
/
-
/
-
-- /
/
-
5500
-
-- ..
? NERD
