贲门失迟缓症临床分析57例  

Achalasia:analysis of 57 cases

作　　者：王建鑫[1] 尚占民[1] 黄皖农[1] 裴艳香[1] 高岩[1] 

机构地区：[1]首都医科大学附属北京朝阳医院消化内科,北京市100020

出　　处：《世界华人消化杂志》2010年第27期2916-2919,共4页World Chinese Journal of Digestology

摘　　要：目的:探讨贲门失弛缓症患者的临床表现、食管体部和下食管括约肌(lower esophageal sphincter,LES)的动力学特征.方法:分析57例确诊为贲门失弛缓症患者的临床表现,并使用荷兰MMS多功能消化管测压仪测定患者和20例健康对照组的LES长度、压力和松弛率,以及食管体部蠕动波的类型和波幅.结果:贲门失弛缓症患者的男女发病比率是1.1∶1,发病年龄25-60岁占80.5%,其主要的临床症状是吞咽困难,反食;贲门失弛缓症患者与健康对照组相比,LES松弛率明显下降(41.5%±18.6%vs96.1%±2.5%,P<0.01),食管体部主要为非传导性同步收缩波(100%vs0,P<0.01),没有推进性蠕动;贲门失弛缓症组的LES长度、压力和食管体部蠕动波波幅与健康对照组比较无显著性差异.结论:LES松弛率下降和食管体部的非推进性同步收缩波是贲门失弛缓症的特征性动力学表现,LES压力增高和食管体部蠕动波幅下降不是诊断的必备条件.本研究对于贲门失弛缓症的早期诊断和治疗方法的选择有指导意义.AIM：To analyze the clinical manifestations of patients with achalasia and to characterize the manometric parameters of the esophageal body and lower esophageal sphincter（LES） in these patients.METHODS：The clinical manifestations of 57 patients with achalasia were analyzed.LES length（LESL）,LES pressure（LESP）,LES relaxation rate（LESRR）,and the type and amplitude of esophageal peristaltic contraction in these patients and 20 healthy controls were measured.A pneumohydraulic capillary perfusion system with 6-lumen Dent-Sleeve catheter from MMS was used to record esophageal manometric parameters.RESULTS：The ratio of male to female for all the 57 patients was 1.1∶1.The majority（80%） of patients ranged in age between 25-60 years.Chief complaints in these patients were dysphagia and regurgitation.LESRR in the achalasia group was signifi cantly lower than that in the healthycontrol group（41.5% ± 18.6% vs 96.1% ± 2.5%,P 0.01）.Aperistalsis in the esophageal body was detected in all achalasia patients but not in healthy controls（100% vs 0,P 0.01）.LESL,LESP and the amplitude of esophageal body showed no significant differences between the achalasia group and healthy control group.CONCLUSION：Incomplete LES relaxation and aperistalsis of the esophageal body are two manometric features of achalasia,and elevated resting LESP and low average contraction amplitude of the esophageal body are not present in all the patients.The results obtained in this study will be helpful for early diagnosis of achalasia and selection of therapeutic modality.

关 键 词：贲门失迟缓症 食管压力测定 下食管括约肌 

分 类 号：R573.7[医药卫生—消化系统]