摘要目的 探讨海勤人员胃食管反流(gastroesophageal reflux,GER)发生与胃食管反流病(gastreesophageal reflux disease,GERD)发病情况.方法 (1)航行前任意2 h、航行开始2 h后,对63名在舰艇工作的健康志愿者,连续2 h实时监测食管下端pH值;同时计算烧心感、胸骨后疼痛、反酸、反食等4种症状的程度和频度积分(symptomatic core,Sc).(2)对某部177名海勤人员和139名陆勤人员进行反流症状问卷调查(reflux diagnostic questionnaire,RDQ),按烧心感、胸骨后疼痛、反酸、反食等4种症状统计、计算RDQ积分.RDQ≥20分者为GERD组,≤15分者为非GERD组,剔除16～19分者(海勤人员39例,陆勤人员31例).(3)对2004年1月至2007年12月我科门诊患者作胃镜检查,Sc积分≥8分者入选为研究对象,胃镜检查排除食管狭窄、消化性溃疡、胃食管肿瘤等疾病后,最终入选的海勤人员187人,陆勤人员251人.结果 (1)航行前Sc积分、pH<4的总时间百分数、反流持续>5 min次数及pH<4的反流次数均显著高于航行2 h时段,症状程度及频度亦同步增加.(2)同卷调查显示:海勤人员组反流症状发生率显著高于陆勤人员组;舰龄>3年者,反流发生率明显增加;(3)Sc症状积分≥8分者,海勤人员反流性食管炎(reflux esophagitis,RE)发病率显著高于陆勤人员组;舰龄>1年者,RE发生率明显增加.结论 (1)航行时较非航行时胃食管酸反流明显增加,症状也明显加重;(2)经常航海的海勤人员反流症状发生率显著高于陆勤人员;(3)海勤人员RE发生率显著高于陆勤人员.

abstractsObjective To investigate gastroesophageal reflux (GER) and morbidity of gastroesophageal reflux disease (GERD) among the shipboard personnel.Methods Real-time esophalgus monitoring of pH was made on 63 healthy subjects of shipboard personnel,two hours before and after deployment at sea.Symptomatic scores (Sc) were analyzed in accordance with heartburn,restrosternal chest pain,acid regurgitation and food regurgitation.177 shipboard personnel and 139 shore-based personnel participated in the reflux diagnostic questionnaire (RDQ) and RDQ scores were analyzed based on the above four symptoms.RDQ score above 20 was classified as the GERD group,the score below 15 as the non GERD group,and those with a score of 16 - 19 were depleted ( including 39 shipboard personnel and 31 shore-based personnel).Subjects were chosen from patients who received gastroseopy from January 2004 to December 2007 and whose symptom score ( Sc ) was either equal or above eight.Further gastroscopy was performed to eliminate those diseases,such as esophagostenosis,peptic ulcer,esophageal neoplasm.Finally,187 shipboard personnel and 251 shore-hased personnel were chose as subjects.Results ( 1 )The accumulated So,the percentage of pH lower than four in total observing time,the number of acid reflux lasting over five minutes and the number of acid reflux with a pH level lower than four pre-deployment were obviously higher than those of two hours after deployment.(2)The questionnaire showed that incidence rate of GER among the shipboard personnel was obviously higher than that of the shore-based personnel;For those with a sea-duty service time above three years,incidence rate of GER increased significantly;(3)For the outpatients whose accumulated Sc was either equal or higher than eight,the occurrence rate of reflux esophagitis (RE) among the shipboard personnel was obviously higher than that of the shore-based personnel.For those with a sea-duty service time above one year,the incidence rate of RE increased significantly.Conclusions ( 1 ) For the shipboard personnel,occurrence rate of gastroesophageal reflux (GER) during deployment at sea was obviously higher than that of post deployment and its symptoms were also obviously severer.(2)The occurrence rate of GER for those who were often deployed at sea was significantly higher than that of the shore-based personnel.(3) The incidence rate of RE among the shipboard personnel was obviously higher than that of the shore-based personnel.