食管下段平滑肌瘤患者的食管高分辨率测压  

High resolution esophageal manometry of patients with lower esophageal leiomyoma

作　　者：冉影 赵威[1] 张莉莉[1] 李婷[1] 王邦茂[1] 

机构地区：[1]天津医科大学总医院消化内科,300052

出　　处：《中华消化杂志》2014年第2期92-95,共4页Chinese Journal of Digestion

摘　　要：【摘要】目的探讨食管下段平滑肌瘤对食管动力学的影响。方法选取食管下段平滑肌瘤患者25例、胃食管反流病（GERD）患者31例与健康对照者16名，比较其食管高分辨率测压检查结果。正态分布的计量资料比较采用t检验和单因素方差分析，非正态分布的计量资料比较采用秩和检验。结果25例食管下段平滑肌瘤患者中，14例伴有反酸、烧心、胸骨后疼痛等胃食管反流症状。食管下段平滑肌瘤组食管下括约肌静息压（LESP）、食管下括约肌松弛率（LESRR）、食管下段压力、蠕动收缩百分比分别为（9．00土6．30）mmHg（1mmHg-0．133kPa）、53．0％（0，334．0％）、（34．66±18．33）mmHg、55．6％（0，100．0％），分别低于健康对照组的（16．25±3．71）mmHg、86．5％（49．0％，103．0％）、（57．75±22．49）mmHg、100．0％（80．0％，100．0％），差异均有统计学意义（t=-4．150，Z=-2．353，t=-3．601，Z=-3．798；P均〈O．05）；但伴与不伴胃食管反流症状的食管下段平滑肌瘤患者食管动力学指标差异均无统计学意义（P均〉O．05）。GERD患者与伴胃食管反流症状的食管下段平滑肌瘤患者食管动力学指标差异均无统计学意义（P均〉0．05）。食管下段平滑肌瘤患者行内镜黏膜下剥离术后LESRR为71．4％（45．5％，150．0％），较术前升高（Z=-2．194，p=0．028）。结论食管下段平滑肌瘤可影响食管运动功能，导致食管抗反流功能下降。食管下段平滑肌瘤合并胃食管反流症状者并不少见。Objective To explore the effects of lower esophageal leiomyoma on esophageal dynamics. Methods A total of 25 patients with lower esophageal leiomyoma, 31 patients with gastroesophageal reflux disease ：（GERD） and 16 healthy controls were selected. The differences of high resolution esophageal manometry results were compared among the groups. The t-test or one way analysis of variance was performed for normally distributed measurement data comparison. Rank sum test was used for non-normally distributed measurement data comparison. Results Among 25 patients with lower esophageal leiomyoma, 14 patients accompanied with acid reflux, heartburn, chest pain or other GERD symptoms. In the group of patients with lower esophageal leiomyoma, the lower esophageal sphincter pressure （LESP）, the lower esophageal sphincter relaxation rate （LESRR）, low esophageal body pressure and peristaltic contraction percentage were （9.00~ 6.30） mmHg （1 mmHg= 0. 133 kPa）, 53. 0% （0, 334.0%） ,（34.66~18.33） mmHg and 55.6~/oo （0, 100.0~）, respectively, which were lower than those of the healthy control group （（16. 25 2_ 3. 71） mmHg, 86. 5~/oo （49. 0%, 103. 0~）, （57. 75 ~ 22.49） mmHg, 100. 0~ （80. 0~, 100. 0~））, and the differences were statistically significant （t= --4.150,Z=--2. 353, t=--3. 601,Z^--3. 798~all P^0. 05）. However there were no significant differences in esophageal dynamics indexes between patients with lower esophageal leiomyoma accompanied GERD symptoms and without GERD symptoms （all P）O. 05）. There were no significant differences in esophageal dynamics indexes between the GERD patients and patients with lower esophageal [eiomyoma accompanied GERD symptoms （all P〉0.05）. LESRR level of patients with lower esophageal leiomyoma （71.4%（45.5%, 150.0%）） increased after endoscopic suhmcosal dissection （Z=-2. 194,P=0. 028）.Conclusions Lower esophageal leiomyoma may anti-reflux esophageal function decline. Lower reflux symptoms are not uncommon. affect esoph

关 键 词：食管肿瘤 平滑肌瘤 测压法 胃食管反流 

分 类 号：R735.1[医药卫生—肿瘤]