难治性胃食管反流病食管动力及反流特点的临床分析  

Characteristics of Esophageal Motility and Reflux in Refractory Gastroesophageal Reflux Disease

作　　者：杨莉丽[1] 邓兴明[1] 张燕燕[1] 邹兵[1] 王俊萍[1] YANG Lili;DNEG Xingming;ZHANG Yanyan;ZOU Bing;WANG Junping(Peking University Shenzhen Hospital,Shenzhen 518036,China)

机构地区：[1]北京大学深圳医院,广东深圳518036

出　　处：《中国医学创新》2021年第9期142-145,共4页Medical Innovation of China

基　　金：深圳市卫生计生系统科研项目(SZXJ2017078)。

摘　　要：目的:分析难治性胃食管反流病(RGERD)的食管动力学状态及反流特点。方法:选取2019年8月-2020年12月本院消化内科收治的60例RGERD患者作为病例组,另选取本院消化内科收治的60例非难治性的胃食管反流病(GERD)患者作为对照组。采用高分辨率食管测压(HREM)监测并比较两组食管动力学参数[食管上端括约肌(UES)压力、食管下端括约肌(LES)压力、LES长度、远端收缩积分(DCI)、收缩前沿速度(CFV)、胃食管连接处收缩积分(EGJ-CI)]。采用24 h食管pH-阻抗监测(24 h MⅡ-pH)监测并比较两组反流指标。结果:病例组UES压力与LES压力均低于对照组(P<0.05);病例组弱酸反流、非酸反流、气体反流及气液混合反流次数均多于对照组(P<0.05)。结论:RGERD患者的食管动力学状态以UES压力及LES压力明显降低为主,反流特点以弱酸、非酸、气体及气液混合反流为主。Objective:To analyze characteristics of esophageal dynamic state and reflux in refractory gastroesophageal reflux disease(RGERD).Method:A total of 60 patients with RGERD admitted to the department of gastroenterology in our hospital from August 2019 to December 2020 were selected as the case group,and another 60 patients with non-refractory gastroesophageal reflux disease admitted to the department of gastroenterology in our hospital from August 2019 to December 2020 were selected as the control group.High resolution esophageal manometry(HREM)was used to monitor and compare the esophageal dynamic parameters[upper esophageal sphincter(UES)pressure,lower esophageal sphincter(LES)pressure,LES length,distal systolic score(DCI),systolic front velocity(CFV),and gastroesophageal junction systolic score(EGJ-CI)]between two groups.The 24 h multichannel intraluminal impedante-pH(24 h MⅡ-pH)was used to monitoring and compare the reflux indexes between the two groups.Result:UES pressure and LES pressure in the case group were lower than those in the control group(P<0.05).The numbers of weak acid reflux,non-acid reflux,gas reflux and gas-liquid mixed reflux in the case group were more than those in the control group(P<0.05).Conclusion:The esophageal dynamic state of patients with RGERD are mainly characterized by significant decrease of UES pressure and LES pressure,and the reflux characteristics are mainly characterized by weak acid,non-acid,gas and gas-liquid mixed reflux.

关 键 词：难治性胃食管反流病 高分辨率食管测压 24h食管pH-阻抗监测 食管动力学 

分 类 号：R571[医药卫生—消化系统]