水灌注高分辨率食管测压及24 h pH-阻抗监测在GERD诊断中的应用价值研究  

Application value of water-perfused high-resolution esophageal manometry and 24 h impedance-pH monitoring in diagnosis of GERD

作　　者：刘洪琴 徐磊[2] 蔡明军[1] 王忠安[3] 胡霞[1] 罗丽娅[1] 

机构地区：[1]贵州省兴义市人民医院消化内科,兴义562400 [2]宁波市第一医院消化内科,宁波712000 [3]贵州省兴义市人民医院神经外科,兴义562400

出　　处：《中华胃食管反流病电子杂志》2016年第2期58-61,共4页Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)

摘　　要：目的探索水灌注高分辨率食管测压及24 h pH-阻抗监测在胃食管反流病(GERD)诊断中的应用价值研究。方法回顾性分析2014年9月至2015年7月,贵州省兴义市人民医院就诊的慢性浅表性胃炎患者为研究对象。对患者进行水灌注导管高分辨率食管测压和pH-阻抗监测即反流监测,鉴别其是否存在GERD。结果经胃镜检查后,无论是否存在典型症状,患者均为慢性浅表性胃炎;从液态高分辨率食管测压结果来看,典型症状和非典型症状的LES压力,UES压力以及食管体部功能,胃食管连接处出口梗阻,胡桃夹食管以及食管裂孔疝情况比较,差异无统计学意义(P>0.05)。从24 h pH-阻抗监测结果来看,典型症状和非典型症状的反酸次数,所有反流次数和非反酸次数比较,差异无统计学意义(P>0.05)。结论通过本研究提示,胃食管反流病作为消化科的常见病、多发病,通过水灌注高分辨率食管测压、24 h pH阻抗监测联合胃镜检查,能够提高食管反流病的诊断率,减少依靠症状诊断的误诊率,特别是在临床工作中,需要与反复发作的慢性胃炎进行鉴别诊断,只有在明确诊断后,才能进行有效的治疗,最终达到缓解患者不适症状的目的,提高治愈率。Objective To explore the application value of water-perfused high-resolution esophageal manometry and 24 h impedance-pH monitoring in diagnosis of gastroesophageal reflux disease（GERD）.Methods Water-perfused high-resolution esophageal manometry and 24 h impedance-pH monitoring（flow monitoring）were performed to identify the patients with GERD,who with the chronic superficial gastritis in Xingyi People＇ s Hospital of Guizhou Province from September 2014 to July 2015 were retrospectively analyzed.Results Comparison of outlet obstruction,nutcracker esophagus and hiatal hernia showed that there was no statistically significant difference（P〉0.05）.Through the 24 h impedance-pH monitoring results,typical and atypical symptoms of acid number,all the flow number and the number of the anti-acid,there was no statistically significant difference（P〉0.05）.Conclusion This study suggested that GERD as the common disease or the frequently-occurring disease in the digestive department should be not only improved the diagnosis of esophageal reflux disease but also reduced the misdiagnosis rate depending on symptom diagnosis by the water-perfused high-resolution esophageal manometry and 24 h impedance-pH monitoring.Especially in the clinical work,the differential diagnosis was essential between GERD and the repeated attack of chronic gastritis.The effective treatment should be carried out after the clear diagnosis,to reach the purpose of easing patients＇ symptoms and improve the cure rate finally.

关 键 词：胃食管反流 胃镜检查 液态高分辨率食管测压 24h pH-阻抗监测 

分 类 号：R571[医药卫生—消化系统]