山莨菪碱试验鉴别假性贲门失弛症和贲门失弛症  

Anisodamine Test in Distinguishing Pseudoachalasia from Idiopathic Achalasia

作　　者：郑炜[1] 陈椿[1] 康明强[1] 林培裘[1] 林若柏[1] 陈舒晨[1] 

机构地区：[1]福建医科大学附属协和医院胸外科,福州350001

出　　处：《福建医科大学学报》2010年第3期202-204,共3页Journal of Fujian Medical University

摘　　要：目的监测山莨菪碱肌注前后食管动力的变化,探讨其在假性贲门失弛症和贲门失弛症鉴别诊断中的价值。方法 10例贲门失弛症和3例胃底贲门癌致假性贲门失弛症的患者,通过8通道袖套式测压导管持续观察食管动力在肌注山莨菪碱前后的变化。结果 10例贲门失弛症患者在肌注山莨菪碱后下食管括约肌松弛程度达47.4%～74.0%,食管体部静息压明显降低;3例假性贲门失弛症患者食管括约肌松弛程度仅2.2%～8.8%,食管体部静息压亦无明显变化。结论山莨菪碱试验可作为贲门失弛症食管测压诊断时的重要补充,也是贲门失弛症和假性贲门失弛症鉴别诊断的手段之一。Objective To distinguish pseudoachalasia from idiopathic achalasia by esophageal manometry before and after intramuscular injection of anisodamine.Methods Ten patiens with idiopathic achalasia and 3 patients with cardia cancer-induced pseudoachalasia were selected in this study.An eight-lumen manometric sleeve assembly was inserted through a nostril into the stomach.The sleeve was astride the lower esophageal sphincter.Esophageal manometry was performed with a polygraphic system（PC POLYGRAF HR） before and after intramuscular injection of anisodamine.Results In the group with idiopathic achalasia,the lower esophageal sphincter relaxation was 47.4% to 74.0% after intramuscular injection of anisodamine,and esophageal body resting pressure obviously decreased.In the group with pseudoachalasia,however,the lower esophageal sphincter relaxation was 2.2% to 8.8%,and there was no obvious change about esophageal body resting pressure.Conclusions Anisodamine test is a significant complement to diagnosing idiopathic achalasia by esophageal manometry,and may be an efficient method for distinguishing idiopathic achalasia from pseudoachalasia.

关 键 词：食管失弛症 山莨菪碱 食管 测压法 

分 类 号：R571[医药卫生—消化系统]