反流性食管炎患者食管动力学临床研究  

Clinical study of esophageal dynamics in patients with reflux esophagitis

作　　者：叶萍[1] 李兆申[1] 许国铭[1] 卢任华[1] 张梅琴[1] 邹多武[1] 尹宁[1] 

机构地区：[1]第二军医大学长海医院消化内科,上海200433

出　　处：《第二军医大学学报》2001年第3期204-206,共3页Academic Journal of Second Military Medical University

基　　金：上海市卫生系统百人计划基金!资助项目 (98BR0 2 6 );上海市青年科技启明星计划资助!项目 (99QB14 0 45 )

摘　　要：目的 :探讨反流性食管炎 (RE)患者的食管动力学方面的改变。 方法 :对胃镜确诊的 45例 RE患者 ,采用 X线透视下观察食管的形态学、蠕动以及反流情况 ,并注意与其他胃肠疾病的关系 ,同时监测 2 4h食管 p H值和食管括约肌 (L ES)压力。 结果 :45例患者 X线表现形态上均有食管粘膜增粗 ,2 2例可见食管痉挛 ,2 4例出现食管反流现象 ,以抽吸型为主 ,占44 .44 % ,廓清以被动廓清为主 ,占 5 5 .5 6 % ,而食管裂孔疝合并 RE患者表现尤甚。 2 4h食管 p H值 <4的总的、卧位和立位反流时间百分比均显著高于对照组 (P<0 .0 1) ,食管裂孔疝合并 RE组 L ES静息压显著低于其他各组 (P<0 .0 5 ) ;L ES的长度各组间无明显差异 ,X线食管钡餐动态观察下的反流情况和反流量与 L ES静息压降低呈正相关性。结论 :RE患者 L ES静息压降低 ,临床上出现反流 ,吸气末加重 ,L ES压力降低可能在 RE发病中起重要的作用。Objective: To study the esophageal dynamics in patients with reflux esophagitis(RE). Methods: Using radiography technique, we assessed the esophageal augmentation, spasm and stricture, the types of reflux and clearance were also studied. Twenty four hours esophageal pH metry and the lower esophageal sphincter (LES)pressure manometry were measured in 45 patients with RE. Results: The radiography showed mucosal augmentation was very common in patients with RE, and 44.44% of patients were with the reflux type of suck and 55.56% with the clearance type of passivity. The percentages of acid exposure time at total,supine and upright were greater in patients with RE than those in controls( P <0.01). Resting LES pressure was lower in patients with severe esophagitis than that in controls( P <0.05). However , there were no differences of length of LES among all groups. Conclusion: The reflux type of suck and clearance type of passivity are very important to RE. Esophageal acid exposure time is not correlated with the severity of esophagitis. Lowed LES resting pressure may play an important role in the pathogenesis of RE. [

关 键 词：反流性食管炎 PH监测 食管测压 食管动力学 

分 类 号：R571[医药卫生—消化系统]