胃内镜联合多通道食管腔内阻抗-pH监测在诊断反流性食管炎中的临床价值  

Clinical value of gastric endoscopy combined with multichannel intralumminal impedance-pH monitoring in the diagnosis of reflux esophagitis

作　　者：张琼[1] 何菡 ZHANG Qiong;HE Han(Department of Gastroenterology,Guangyuan Third People Hospital,Guangyuan 628001,China;Department of Gastroenter-ology,Liangshan First Peopled Hospital,Yi Autonomous Prefecture,Xichang 615000,China)

机构地区：[1]四川省广元市第三人民医院消化内科,四川广元628001 [2]四川省凉山彝族自治州第一人民医院消化内科,四川西昌615000

出　　处：《实用医院临床杂志》2018年第5期98-101,共4页Practical Journal of Clinical Medicine

摘　　要：目的分析胃内镜联合多通道食管腔内阻抗-p H(MⅡ-p H)监测在诊断反流性食管炎(RE)中的应用价值。方法我院胃肠功能室进行胃镜、24 h MⅡ-p H监测的220例反流性食管炎患者为观察组,同期我院体检的60例健康正常人为对照组,总结反流性食管炎患者24 h MⅡ-p H临床表现,统计胃镜、24 h MⅡ-p H诊断RE阳性率。结果 24 h MⅡ-p H诊断RE阳性率高于胃镜、24 h p H-De M,胃镜+24 h MⅡ-p H诊断RE阳性率高于单纯胃镜、24 h p H-De M、24 h MⅡ-p H检查(P<0.05)。观察组立位和卧位总反流、酸反流、弱酸反流及液体反流、混合反流、气体反流中位次数均高于对照组;反流时间>5min次数、最长反流次数、总p H、立位p H、卧位p H、De M积分均高于对照组(P<0.05)。结论胃镜联合24 h MⅡ-p H监测可弥补常规胃镜诊断的不足,可明确RE患者食管反流特点及反流理化性质,对RE诊断价值较高。Objective To analyze the clinical value of gastric endoscopy combined with multichannel intralumminal impedance-pH （M II-pH） monitoring in the diagnosis of reflux esophagitis （R E ） . Methods Two hundred and twenty patients with RE who underwent gastroscopy and 24 h M II-pH monitoring in the gastrointestinal function room of our hospitals were included in an observation group.Another 60 normal healthy people who underwent health examination during the same period were selected as a control group.The clinical manifestations of 24 hM II-pH in patients with RE were summarized, and the positive rates of RE diagnosed by gastroscopy and 24 hM II-pH were statistically analyzed.Results The positive rate of RE diagnosed by 24 h M II-pH was higher than that by gas-troscopy or 24 h pH-DeM （ P〈0.05） , and the positive rate of RE diagnosed by gastroscopy combined with 24 h M II-pH was higher than that by simple gastroscopy,24 h pH-DeM or 24 h M II-pH （P 〈 0.05）.The total times of orthostatic and supine reflux,acid reflux and weak acid reflux in the observation group was more than that in the control group （P〈0.05 ）.The median times of orthostatic and su-pine liquid reflux, mixed reflux and gas reflux in the observation group was more than that in the control group （ P〈0.05 ）.The times of time for reflux 〉 5 min, times of the longest reflux, total pH, orthostatic pH, supine pH and DeM score in the observation group were more or higher than those in the control group （ P 〈0.05 ） .Conclusion Gastroscopy combined with 24 h M II-pH monitoring can make up for the deficiency of routine gastroscopy, and can make clear the characteristics of reflux and physicochemical properties of RE. It is of great value in the diagnosis of RE.

关 键 词：反流性食管炎 胃镜 多通道食管腔内阻抗-pH监测 诊断 

分 类 号：R573.3[医药卫生—消化系统]