贲门失驰缓症及滑动型食管裂孔疝患者食管多通道阻抗-压力测定分析  

An analysis of combined multichannel intraluminal impedance and esophageal manometry in achalasia and sliding hiatal hernia patients

作　　者：曲玥[1,2] 叶京英[1,2] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,100730 [2]耳鼻咽喉头颈外科学教育部重点实验室,北京100069

出　　处：《中华胃食管反流病电子杂志》2014年第1期15-18,共4页Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)

基　　金：国家自然科学基金资助项目(No.81371079)

摘　　要：目的应用食管联合多通道阻抗-压力测定(MII-EM)技术研究贲门失驰缓症及滑动型食管裂孔疝患者的食管动力异常特点。方法连续选取2013年4月至2014年6月到首都医科大学附属北京同仁医院就诊,入组内镜或食管造影诊断的贲门失驰缓症患者6名、滑动型食管裂孔疝患者10名以及健康志愿者10名行MII-EM检查,分析比较二个患病组与对照组间各检测指标差异。结果与对照组相比,二个患病组的食团传送率均显著降低。贲门失驰缓症患者LES残余压显著升高,同步收缩及逆行收缩率明显增加,LES松弛率显著降低,食管中上段收缩压力也减低(P<0.05),但未发现其在LES静息压、LES长度、及UES各功能指标上的差异。滑动型食管裂孔疝患者LES静息压较对照组显著降低,UES舒张时间延长,食管近端收缩压力减低(P<0.05),但未发现食管中、下段收缩功能的异常。结论 MII-EM技术能够评估贲门失驰缓症及滑动型食管裂孔疝的食管功能障碍,具有一定的辅助诊断价值。Objective To investigate the abnormal esophageal motility in achalasia and sliding hiatal hernia patients using combined multichannel intraluminal impedance and esophageal manometry（MII-EM）.Methods Consecutive 10 patients with sliding hiatal hernia and 6 patients with achalasia diagnosed by endoscopy or esophageal dynamic radio-graphy were enrolled,and also 10 healthy volunteers in Beijing Tongren Hospital,Capital Medical University.All objects underwent MII-EMexamination.Differences were compared between the detection indexes of either patient group and the control.Results Both the patient groups showed a significantly lower Complete Bolus Transit Rate compared to the control.The achalasia group had significantly higher LES residual pressure,more esophageal simultaneous contractions and retrograde contractions ,lower LES percent relaxation and proximal-mid esophageal constriction amplitude （P 〈0.05）compared to the control.No significant differences were found in LES pressure,LES length, and any functional indexes of upper esophageal sphincter （UES）between the achalasia group and the control.The sliding hiatal hernia group had a significantly lower LES pressure,longer UES relaxation duration,and lower proximal esophageal constriction amplitude （P 〈0.05 ）.No mid-distal esophageal functional abnormities were found in sliding hiatal hernia group.Conclusion MII-EM can help evaluate the esophageal dysfunction in achalasia and sliding hiatal hernia patients,and may help with diagnosis.

关 键 词：食管联合多通道阻抗-压力测定 贲门失驰缓症 疝 食管裂孔 

分 类 号：R655.4[医药卫生—外科学]