118例难治性胃食管反流病患者的胃镜及食管动力特点  

Gastroscopy and Esophageal Manometry Characteristics of 118 Refractory Gastroesophageal Reflux Disease

作　　者：袁莉莉 季锋[1] 李治仝[1] 白林峰[1] 李成栋 YUAN Li-li;JI Feng;LI Zhi-tong;BAI Lin-feng;LI Cheng-dong(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院,河南郑州450052

出　　处：《河南医学研究》2020年第9期1565-1568,共4页Henan Medical Research

摘　　要：目的分析难治性胃食管反流病(GERD)胃镜和高分辨率测压(HRM)结果,比较难治性GERD不同内镜下类型的食管动力特征。方法回顾性分析2017年9月至2019年6月于郑州大学第一附属医院就诊的118例难治性GERD患者的胃镜和HRM结果,依据胃镜下类型分为反流性食管炎(RE)组、非糜烂性胃食管反流病(NERD)组和Barrett食管(BE)组,比较内镜与HRM对食管裂孔疝(HH)的检出率,以及3组间的完整松弛压力(IRP)、上食管括约肌(UES)压力和无效收缩率。结果HRM对HH的检出率[12.7%(15/118)]高于内镜对HH的检出率[8.5%(10/118)],差异无统计学意义(P>0.05)。3组间IRP和UES压力比较,差异无统计学意义(P>0.05)。RE组无效收缩率高于NERD组,差异有统计学意义(P<0.05);RE组与BE组、NERD组与BE组无效收缩率比较,差异无统计学意义(P>0.05)。RE组HH发生率[16.2%(6/37)]与NERD组[13.8%(9/65)]比较,差异无统计学意义(P>0.05)。结论RE较NERD更易发生无效收缩,难治性GERD不同内镜下类型可能存在不同食管动力特点,需对此类患者展开个体化治疗。Objective To analyze the endoscopic and high resolution manometry(HRM)results of refractory gastroesophageal reflux disease(GERD)patients,and compare the esophageal dynamic characteristics of different endoscopic presentation.Methods The endoscopic and HRM results of 118 refractory GERD patients in the First Affiliation Hospital of Zhengzhou University from September 2017 to June 2019 were analyzed.The patients were classified into reflux esophagitis(RE)group,non-erosive reflux disease(NERD)group and Barrett’s esophagus(BE)group.The detection rate on hiatal hernia(HH)of HRM and endoscopy,integrated reflaxation pressure(IRP),upper esophageal sphincter(UES)pressure and the invalid peristalsis rate were compared among RE,NERD and BE group.Results The detection rate for HH was higher of HRM(12.7%)than endoscopy(8.5%),and the difference was statistically significant(P>0.05).There was no statistically significant difference of IRP and UES pressure in three groups(P>0.05).The invalid peristalsis rate of RE was higher than NERD,and the difference was statistically significant(P<0.05).There were no statistically significant differences of invalid peristalsis rate between RE group and BE group,NERD group and BE group(P>0.05).There was no statistically significant difference of HH rate between RE and NERD group(P>0.05).Conclusion RE is more prone to ineffective contraction than NERD,and refractory GERD may have different esophageal dynamic characteristics under different types of endoscopy,so individualized treatment should be conducted for such patients.

关 键 词：胃食管反流病 高分辨率测压 食管裂孔疝 

分 类 号：R571[医药卫生—消化系统]