不同食团对非梗阻性食管源性吞咽困难患者食管动力的影响  

Effects of different food bolus on esophageal motility in patients with non-obstructive esophageal dysphagia

作　　者：陈智颖[1] 王朝晖[1] 袁召[1] 

机构地区：[1]大连市中心医院消化内科,辽宁省116033

出　　处：《中华消化杂志》2017年第11期739-742,共4页Chinese Journal of Digestion

摘　　要：目的应用高分辨率食管测压分析不同食团对非梗阻性食管源性吞咽困难患者食管动力的影响。方法纳入2014年3月至2015年6月就诊的48例非梗阻性食管源性吞咽困难患者和12名健康志愿者（健康对照组），进行液体吞咽、黏胶吞咽、固体吞咽的高分辨率食管测压检查，分析食管下括约肌压力（LESP）、4S完整松弛压（4SIRP）、远端收缩积分（DCI）、远端潜伏期（DL）和收缩中断等指标。统计学方法采用t检验。结果根据2014芝加哥分类标准，48例吞咽困难患者中，食管动力异常者35例（72．9％），其中最常见的食管动力障碍类型是无效食管动力[31．2％（15／48）]；食管动力功能完全正常者13例（27．1％）。健康对照组LESP为（10．85±3．75）mmHg（1mmHg=0．133kPa），4s IRP为（1．90±0．84）mmHg；吞咽困难组LESP为（12．20±8．93）mmHg，4SIRP为（3．25±1．02）mmHg;两组LESP、4s IRP比较差异均无统计学意义（P均〉0.05）。健康对照组液体吞咽、黏胶吞咽和固体吞咽的DCl分别为（589．00±292．90）、（690．17±52．41）和（808．00±448．53）mmHg·s·cm，分别低于芝加哥分类完全正常组的（1346．62±244．83）、（1542．46±231．19）和（1890．31±363．26）mmHg·s·cm，差异均有统计学意义（t=4．76、4．68、3．79，均P=0．001）；健康对照组固体吞咽DL为（7．72±1．15）S，低于芝加哥分类完全正常组的（9．00±1．23）s，差异有统计学意义（t=2．61，P=0．021）；健康对照组液体吞咽、黏胶吞咽和固体吞咽的收缩中断分别为（2．33±1．74）、（2．37±1．72）和（1．53±1．22）cm，分别高于芝加哥分类完全正常组的（0.58±0．48）、（0.52±0．47）和（0.85±0．53）cm，差异均有统计学意义（t=3．02、3．68、2．54，P均〈0.05）。结论非梗阻性食管源性吞咽困难患者最常见的食管动力障碍类型是无效食管动�Objective To analyze the effects of different food bolus on esophageal motility in patients with non-obstructive esophageal dyshagia by high-resolution esophageal manometry. Methods From March 2014 to June 2015, 48 patients with non-obstructive esophageal dysphagia and 12 healthy volunteers （healthy control group） were enrolled. High-resolution manometry was tested when swallowing liquid food, semisolid food and solid food. The lower esophageal sphincter pressure （LESP）, 4 second integrated relaxation pressure （4 s IRP）, distal contractile integral （DCI）, distal latency （DL）, and breaks were analyzed. T test was performed for statistical analysis. Results According to the 2014 Chicago classification standard, among 48 patients with dysphagia, esophageal dysmotility was diagnosed in 35 patients （72.9%）, while 13 patients （27.1%） had normal esophageal motility, and the most common type of esophageal motility disorder was ineffective esophageal motility （31. 2± 15/48）. The LESP of the healthy control group was （10.85±3.75） mmHg （1 mmHg=0. 133 kPa） and 4 s IRP was （1.90±0.84） mmHg. The LESP of dysphagia group was （12. 20±8. 93） mmHg and 4 s IRP was （3.25±1.02） mmHg. There was no significant difference in LESP and 4 s IRP between two groups （both P）0.05）. The DCIs of liquid swallows, semisolid swallows and solid swallows of healthy control group were （589.00±292.90）, （690.17±52.41） and （808.00±448.53） mmHg ·s· cm, respectively, which were significantly lower than those of complete normal group in Chicago classification （（1 346.62± 244.83）, （1 542.46±231.19） and （1 890.31±363.26） mmHg · s · cm; t=4. 76,4. 68 and 3.79; all P=0. 001）. The DL of solid swallows of healthy control group was （7. 72± 1. 15） s, which was significantly lower than that of complete normal group in Chicago classification （（9.00±1.23） s; t=2.61, P=0. 021）. The breaks of liquid swallows, semisolid swallows and solid swallows of healthy

关 键 词：高分辨率食管测压 非梗阻性食管源性吞咽困难 不同食团吞咽 

分 类 号：R571[医药卫生—消化系统]