發(fā)布時(shí)間：2018-02-23 22:05

  本文關(guān)鍵詞： 彌漫性食管痙攣 食管測(cè)壓 臨床表現(xiàn) 診斷　出處：《廣東醫(yī)學(xué)》2016年12期 　論文類型：期刊論文

【摘要】：目的探討彌漫性食管痙攣(DES)的臨床表現(xiàn)及食管測(cè)壓特點(diǎn)。方法回顧性分析對(duì)比84例DES患者(DES組)及60例反流性食管炎患者(RE組)的臨床資料,分析其臨床表現(xiàn)、胃鏡、鋇餐及食管測(cè)壓結(jié)果。結(jié)果 (1)臨床表現(xiàn):DES組以胸痛和吞咽困難為主,RE組以胸痛、反酸、燒心為主,兩組相比差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(2)胃鏡檢查:胃鏡檢查診斷DES、RE的陽(yáng)性率分別為29.7%、50.0%,兩者差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(3)鋇餐檢查:食管鋇餐在診斷DES、RE的陽(yáng)性率分別為28.5%、71.6%,兩者差異有統(tǒng)計(jì)學(xué)意義(P0.05)。(4)食管測(cè)壓:DES組在食管測(cè)壓檢測(cè)中食管體部出現(xiàn)同步收縮波、多發(fā)重復(fù)收縮波占73.8%,濕咽成功率為62.36%。RE組食管體部近端和遠(yuǎn)端壓力、下食管括約肌壓力、食管括約長(zhǎng)度均低于正常值,多發(fā)重復(fù)收縮波占20.0%,濕咽成功率84.2%,兩者差異有統(tǒng)計(jì)學(xué)意義(P0.01)。結(jié)論 DES臨床表現(xiàn)以胸痛和吞咽困難為主,且與病變部位相一致,以食管中上段為主;而反流性食管炎病變以食管中下段為主。食管測(cè)壓是診斷DES較為準(zhǔn)確的方法,較胃鏡和鋇餐更準(zhǔn)確,有助于提高DES診斷,做到早期診斷,以減少誤診。
[Abstract]:Objective to investigate the clinical manifestations and esophageal manometry of diffuse esophageal spasm (des). Methods the clinical data of 84 DES patients with des) and 60 patients with reflux esophagitis (RE) were analyzed retrospectively. Barium meal and esophageal manometry. Results 1) the clinical manifestations of the group were chest pain and dysphagia. The RE group was characterized by chest pain, acid regurgitation and heartburn. Gastroscopy: the positive rate of gastroscopy in the diagnosis of DESRE was 29.70.00.The difference between the two groups was statistically significant (P0.05. 3) barium meal examination: the positive rate of esophageal barium meal in the diagnosis of DESREE was 28.5571.6, respectively, and there was a difference between the two groups. There were synchronous contractions in the esophageal body in the esophageal manometry group (P < 0.05) and the esophageal body contraction wave in the esophageal manometry group (n = 10), while in the esophageal manometry group, a synchronous contraction wave appeared in the esophageal body. The success rate of wet pharynx was 62.36.RE group had lower esophageal sphincter pressure, lower esophageal sphincter pressure, lower esophageal sphincter pressure and lower esophageal sphincter length than normal. Multiple repeated contractions accounted for 20.0%, and the success rate of wet pharynx was 84.2%. The difference was statistically significant (P 0.01). Conclusion the clinical manifestations of DES are mainly chest pain and dysphagia, which are consistent with the location of the lesion and mainly in the middle and upper esophagus. Esophageal manometry is a more accurate method for diagnosing DES, which is more accurate than gastroscopy and barium meal. It is helpful to improve the diagnosis of DES and to make early diagnosis so as to reduce misdiagnosis.
【作者單位】： 中國(guó)人民解放軍第169醫(yī)院暨湖南師范大學(xué)附屬湘南醫(yī)院消化內(nèi)科;
【分類號(hào)】：R571

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