Accurate positioning of the 24-hour pH monitoring catheter:Agreement between manometry and pH step-up method in two patient positions

瞄准：在二个不同耐心的位置调查在食道的测压法和 pH 加速方法之间的协议。方法：十八个题目在学习被包括。首先，到更低的食道的括约肌(LES ) 的近似边阶的从鼻子的距离被测量压力计的联盟者。然后一个不同调查者，被使看不见第一研究的结果，用 pH 加速方法测量了一样的距离，与病人在一起正直并且背卧位。对在二种技术之间的同意的一个评价被执行。结果：在背卧位，仅仅一个题目的测量在为正确的放接受的范围(对 LES 3 厘米远侧或近似的 【=) 外面。在正直的位置，在测量的错误在五个题目被认出。Bland-Altman 阴谋表明在大小之间的好同意获得了压力计的联盟者并且由在与在背卧位的病人一起的方法上面的 pH 步。结论：在情况中非压力计的察觉设备的可获得性， pH 加速方法能便于放在背卧位与病人一起监视导管的 24 h pH。如果我们的结果被进一步的研究支持，这应该与怀疑的胃的食道的倒流疾病为题目在临床的实践增加 pH-metry 的使用。

AIM： TO investigate the agreement between esophageal manometry and pH step-up method in two different patient positions. METHODS： Eighteen subjects were included in the study. First, the distance from the nose to the proximal border of the lower esophageal sphincter （LES） was measured manometrically. Then a different investigator, who was blinded to the results of the first study, measured the same distance using the pH step-up method, with the patient in both upright and supine positions. An assessment of agreement between the two techniques was performed. RESULTS： In the supine position, the measurement of only one subject was outside the range accepted for correct positioning （~〈 3 cm distal or proximal to the LES）. In the upright position, errors in measurement were recognized in five subjects. Bland-Airman plots revealed good agreement between measurements obtained manometrically and by the pH-step up method with the patient in the supine position. CONCLUSION： In the case of nonavailability of manometric detection device, the pH step-up method can facilitate the positioning of the 24 h pH monitoring catheter with the patient in the supine position. Thisshould increase the use of pH-metry in clinical practice for subjects with suspected gastroesophageal reflux disease if our results are supported by further studies.