目的总结分析高分辨率食管测压联合食管24 h pH监测在外科诊断及治疗胃食管反流病中的应用价值。方法选取新疆维吾尔自治区人民医院2014年1月至12月期间收治的70例有胃食管反流病症状经临床检查拟诊为胃食管反流病的患者,行高分辨率食...目的总结分析高分辨率食管测压联合食管24 h pH监测在外科诊断及治疗胃食管反流病中的应用价值。方法选取新疆维吾尔自治区人民医院2014年1月至12月期间收治的70例有胃食管反流病症状经临床检查拟诊为胃食管反流病的患者,行高分辨率食管测压、食管24 h pH监测。结果 70例患者中,确诊为胃食管反流病患者50例(71.4%),其中经高分辨率食管测压诊断有食管裂孔疝者32例(64%),无食管裂孔疝者18例(36%)。非胃食管反流病患者20例(28.6%),其中经高分辨率食管测压诊断有食管裂孔疝者4例(20%),无食管裂孔疝者16例(80%)。结论胃食管反流病患者中合并食管裂孔疝者居多,高分辨率食管测压与食管24 h pH监测对胃食管反流病患者的诊断和外科治疗术式的选择具有指导意义。展开更多
Globus is a persistent or intermittent non-painful sensation of a lump or foreign body in the throat.It is a commonly encountered clinical condition that is usually long-lasting,difficult to treat,and has a tendency t...Globus is a persistent or intermittent non-painful sensation of a lump or foreign body in the throat.It is a commonly encountered clinical condition that is usually long-lasting,difficult to treat,and has a tendency to recur.Furthermore,due to the uncertain etiology of globus,it remains difficult to establish standard investigation and treatment strategies for affected patients. As a first step for managing globus,careful history taking and nasolaryngoscopy are essential.Given the benign nature of the condition and the recent notion that gastroesophageal reflux disease is a major cause of globus,empirical therapy with a high dose of proton pump inhibitors is reasonable for patients with typical globus.If patients are nonresponsive to this therapy, definitive assessments such as endoscopy,multichannel intraluminal impedance/pH monitoring,and ma-nometry should be considered.Speech and language therapy,anti-depressants,and cognitive-behavioral therapy can be helpful in patients whose symptoms persist despite negative investigations.展开更多
目的评估胃蛋白酶试纸条检测诊断咽喉反流的可行性。方法对2017年8月至2018年9月在解放军总医院第六医学中心耳鼻咽喉头颈外科就诊且可疑咽喉反流的80例患者,同时行胃蛋白酶试纸条检测和24 h多通道腔内阻抗(multichannel intraluminal i...目的评估胃蛋白酶试纸条检测诊断咽喉反流的可行性。方法对2017年8月至2018年9月在解放军总医院第六医学中心耳鼻咽喉头颈外科就诊且可疑咽喉反流的80例患者,同时行胃蛋白酶试纸条检测和24 h多通道腔内阻抗(multichannel intraluminal impedance,MII)-pH监测。将两种诊断方法的结果行一致性分析,并以24 h MII-pH监测为参照统计胃蛋白酶试纸条检测诊断咽喉反流的敏感度和特异度。采用SPSS 19.0统计学软件进行统计学分析。结果胃蛋白酶试纸条检测阳性患者57例,阴性患者23例。胃蛋白酶试纸条检测阳性患者的反流症状和体征评分、咽喉反流事件阳性率显著高于阴性患者。若以存在1次及以上的咽喉反流事件(包括酸反流、弱酸反流和碱反流)作为24 h MII-pH监测阳性结果来参照,则胃蛋白酶试纸条检测和24 h MII-pH监测结果的一致性中等(Kappa值=0.614),胃蛋白酶试纸条检测的敏感度为86.9%(53/61)、特异度为78.9%(15/19)。结论胃蛋白酶试纸条检测有无创、价廉和易于操作的优点,作为一种初期诊断咽喉反流的客观方法是可行的,但不能作为最终诊断咽喉反流性疾病的标准。展开更多
文摘目的总结分析高分辨率食管测压联合食管24 h pH监测在外科诊断及治疗胃食管反流病中的应用价值。方法选取新疆维吾尔自治区人民医院2014年1月至12月期间收治的70例有胃食管反流病症状经临床检查拟诊为胃食管反流病的患者,行高分辨率食管测压、食管24 h pH监测。结果 70例患者中,确诊为胃食管反流病患者50例(71.4%),其中经高分辨率食管测压诊断有食管裂孔疝者32例(64%),无食管裂孔疝者18例(36%)。非胃食管反流病患者20例(28.6%),其中经高分辨率食管测压诊断有食管裂孔疝者4例(20%),无食管裂孔疝者16例(80%)。结论胃食管反流病患者中合并食管裂孔疝者居多,高分辨率食管测压与食管24 h pH监测对胃食管反流病患者的诊断和外科治疗术式的选择具有指导意义。
基金Supported by A Pusan National University Hospital Clinical Research Grant(2011)a grant from the National R and D Program for Cancer Control,Ministry for Health,Welfare and Family Affairs,Republic of Korea,No.0920050
文摘Globus is a persistent or intermittent non-painful sensation of a lump or foreign body in the throat.It is a commonly encountered clinical condition that is usually long-lasting,difficult to treat,and has a tendency to recur.Furthermore,due to the uncertain etiology of globus,it remains difficult to establish standard investigation and treatment strategies for affected patients. As a first step for managing globus,careful history taking and nasolaryngoscopy are essential.Given the benign nature of the condition and the recent notion that gastroesophageal reflux disease is a major cause of globus,empirical therapy with a high dose of proton pump inhibitors is reasonable for patients with typical globus.If patients are nonresponsive to this therapy, definitive assessments such as endoscopy,multichannel intraluminal impedance/pH monitoring,and ma-nometry should be considered.Speech and language therapy,anti-depressants,and cognitive-behavioral therapy can be helpful in patients whose symptoms persist despite negative investigations.
文摘目的评估胃蛋白酶试纸条检测诊断咽喉反流的可行性。方法对2017年8月至2018年9月在解放军总医院第六医学中心耳鼻咽喉头颈外科就诊且可疑咽喉反流的80例患者,同时行胃蛋白酶试纸条检测和24 h多通道腔内阻抗(multichannel intraluminal impedance,MII)-pH监测。将两种诊断方法的结果行一致性分析,并以24 h MII-pH监测为参照统计胃蛋白酶试纸条检测诊断咽喉反流的敏感度和特异度。采用SPSS 19.0统计学软件进行统计学分析。结果胃蛋白酶试纸条检测阳性患者57例,阴性患者23例。胃蛋白酶试纸条检测阳性患者的反流症状和体征评分、咽喉反流事件阳性率显著高于阴性患者。若以存在1次及以上的咽喉反流事件(包括酸反流、弱酸反流和碱反流)作为24 h MII-pH监测阳性结果来参照,则胃蛋白酶试纸条检测和24 h MII-pH监测结果的一致性中等(Kappa值=0.614),胃蛋白酶试纸条检测的敏感度为86.9%(53/61)、特异度为78.9%(15/19)。结论胃蛋白酶试纸条检测有无创、价廉和易于操作的优点,作为一种初期诊断咽喉反流的客观方法是可行的,但不能作为最终诊断咽喉反流性疾病的标准。
