摘要
目的通过高分辨率食管测压探讨不同食团和吞咽方式对胃食管反流病患者食管测压结果的影响。方法将胃食管反流病问卷评分≥8分且24hpH监测阳性患者纳入研究,分别采取液体吞咽、固体吞咽和连续吞咽三种方式进行食管动力检测,按照芝加哥标准进行参数和综合诊断对比。结果研究共纳入42例胃食管反流病患者,与液体吞咽食管动力参数比较,固体吞咽食管上括约肌残余压降低[(11.07±3.97、5.29±3.36)mmHg],远端收缩延迟时间延长[(6.28±1.87、8.98±2.25)s],食管下括约肌松弛时间延长[(7.79±0.98、10.69±13.04)s],差异有统计学意义(P<0.05)。在食管动力综合诊断中,与液体吞咽(38.1%)相比,连续吞咽无效食管动力诊断阳性率(63.2%)明显增高,差异具有统计学意义(P=0.008),而固体吞咽无效食管动力诊断阳性率(45.2%)轻度增高,差异无统计学意义(P=0.581)。在无效收缩中,固体吞咽收缩失败占比(44.3%)高于液体吞咽(22.6%)。结论固体吞咽较液体吞咽更易诱发重度食管低动力障碍,连续吞咽在无效食管动力诊断中敏感性高,可作为胃食管反流病患者常规测压的补充检查。
Objective To investigate the effects of different bolus and swallow patterns on esophageal manometry in patients with gastroesophageal reflux disease by high resolution manometry.Methods Patients with gastroesophageal reflux disease questionnaire score of more than8points and positive24hour pH monitoring were included in the study.All the patients were detected by liquid swallow,solid swallow and continuous swallow.The parameters and comprehensive diagnosis were in accordance with the Chicago Standard.Results A total of42patients with gastroesophageal reflux disease were enrolled.Compared with the dynamic parameters of liquid swallow,the residual pressure of upper esophageal sphincter[(11.07±3.97,5.29±3.36)mmHg]decreased,the distal latency[(6.28±1.87,8.98±2.25)s],and lower esophageal sphincter relaxation time[(7.79±0.98,10.69±13.04)s]prolonged significantly(all P<0.05).In the comprehensive diagnosis of esophageal motility,compared with liquid swallow(38.1%),continuous liquid swallow showed a more sensitive positive diagnostic rate of ineffective esophageal motility(IEM)(63.2%),with a significant difference(P=0.008).Compared with that of liquid swallow,the diagnostic rate(45.2%)of IEM by the solid swallow did not differ significantly(P=0.581).Among the ineffective contraction,the rate of failed contraction(44.3%)of solid swallow was higher than that of liquid swallow(22.6%).Conclusion Solid swallow is more likely to induce severe esophageal hypomotility disorders than liquid swallow.Continuous swallow has more sensitivity in the diagnosis of IEM.Therefore,it can be used as a supplement to routine manometry in patients with gastroesophageal reflux disease.
作者
殷燕
许晓毓
赵艳
任晓阳
卢桂芳
闫小妮
董蕾
和水祥
YIN Yan;XU Xiao-yu;ZHAO Yan;REN Xiao-yang;LU Gui-fang;YAN Xiao-ni;DONG Lei;HE Shui-xiang(Department of Gastroenterology,the First Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061;Department of Gastroenterology,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)
出处
《西安交通大学学报（医学版）》
CAS
CSCD
北大核心
2018年第1期88-92,共5页
Journal of Xi’an Jiaotong University（Medical Sciences）
基金
陕西省科技统筹创新工程计划项目(No.2016KTZDSF02-02)~~
关键词
高分辨率食管测压
固体吞咽
连续吞咽
测压参数
无效食管动力
high resolution manometry
solid swallow
continuous swallow
manometric parameter
ineffective esophageal motility
