高分辨率食管测压联合24小时pH阻抗技术在胃食管反流病合并食管裂孔疝中的应用  

Application of high-resolution esophageal manometry combined with 24-hour pH impedance technique for gastroesophageal reflux disease with esophageal hiatal hernia

作　　者：高红雷[1] 徐慧民[1] 徐冬梅[1] 肖相明 张文星[1] 孙作成[1] Gao Honglei;Xu Huimin;Xu Dongmei;Xiao Xiangming;Zhang Wenxing;Sun Zuocheng(Weifang people's hospital,Weifang,Shandong,261041,China)

机构地区：[1]山东省潍坊市人民医院普外胃肠外科,261041

出　　处：《中华胃食管反流病电子杂志》2021年第1期16-19,共4页Chinese Journal Of Gastroesophageal Reflux Disease(Electronic Edition)

基　　金：潍坊市卫生计生委科研项目计划(2016wsjs105)。

摘　　要：目的探讨高分辨率食管测压(HRM)联合24 h pH阻抗技术技术在胃食管反流病合并食管裂孔疝的诊断及腹腔镜胃底折叠术式选择。方法回顾性分析2015年4月至2019年10月,潍坊市人民医院胃肠外科行胃镜及HRM检查联合24 h pH阻抗技术,确诊为胃食管反流病合并食管裂孔疝并收住普外科的167例患者的临床资料,统计胃镜及HRM检查联合24 h pH阻抗技术诊断胃食管反流病合并食管裂孔疝的确诊率。结果HRM检查联合24 h pH阻抗技术的检出率为83.32%(139/167),特异性为100%(139/139);胃镜确诊为67.06%(112/167):其中由胃镜和HRM均确诊112例患者,约占80.57%(112/139),HRM技术的检出率明显高于胃镜;其中105例行腹腔镜治疗食管裂孔疝修补术联合胃底折叠术,7例患者及家属因各种原因放弃手术选择内科保守治疗。结论HRM检查联合24 h pH阻抗技术较胃镜对胃食管反流病合并食管裂孔疝的诊断具有更高的特异性,并能够有效地指导胃底折叠手术方案。0bjecfive To explore the clinical basis for the diagnosis of gastroesophageal reflux disease combined with hiatal hernia and the selection of laparoscopic fundus folding surgery by high resolution esophageal manometer(HRM)combined with 24-hour pH impedance technique.Methods From April 2015 to October 2019,167 patients were diagnosed with gastroesophageal reflux disease combined with hiatal hernia and performed operations in Weifang people's hospital.The diagnosis rate of gastroesophageal reflux disease combined with hiatal hernia by gastroscopy and HRM combined with 24-hour pH impedance was calculated,and the status and role of gastroesophageal reflux disease combined with hiatal hernia in minimally invasive treatment of hiatal hernia were summarized.Results The detection rate of HRM combined with 24-Hour pH impedance technique was 83.32%(139/167),and the specificity was 100%(139/139),and the confirmed by gastroscopy was 67.06%(112/167).Among them,112 patients were diagnosed by gastroscopy and HRM,accounting for 80.57%(112/139).The detection rate of HRM combined with 24-Hour pH impedance technique was significantly higher than gastroscopy;105 cases were treated with laparoscopic esophageal hiatal hernia repair combined with gastric fundus folding,and 7 patients gave up surgery to choose conservative treatment.Conclusion Compared with gastroscope,HRM examination combined with 24-hour pH impedance technique has higher specificity in the diagnosis of gastroesophageal reflux disease combined with hiatal hernia,and can effectively guide the gastric fundus folding operation..

关 键 词：胃食管反流病 食管裂孔疝 胃底折叠术 高分辨率食管测压 24 h pH阻抗技术 

分 类 号：R571[医药卫生—消化系统]