59例食管疾病的食管压力测定

Esophageal manometry in 59 patients with esophageal diseases

目的：研究食管疾病患者食管动力改变。方法：共研究５９例食管疾病患者食管测压表现，另取１２例正常人作为对照。结果：３６例原发性食管运动障碍患者中，６例诊断为贲门失弛缓，表现为下食管括约肌压力（ＬＥＳＰ）升高，吞咽后松弛不全，２例自发同时性收缩明显增加、食管原发性蠕动消失，诊断为弥漫性食管痉挛；２８例诊断为非特异食管运动功能障碍，表现为多种食管动力异常。１０例食管癌及９例贲门癌患者，病灶局部均呈高压区，伴周围食管体部继发运动障碍。４例糖尿病患者食管测压见ＬＥＳＰ降低，食管体部蠕动幅度降低。结论：食管测压对诊断原发性与继发性食管运动障碍均有较大价值。

Objective: To investigate the changes of esophageal motility in patients with esophageal diseases. Methods: Esophageal manometry was done in 59 cases of esophageal diseases, including 36 primary esophageal motility disorders, 10 esophageal cancer, 9 cardiac cancer and 4 diabetes mellitus. The results were compared with those of 12 normal controls. Results: Among 36 patients with primary esophageal motility disorders, there were 6 cases who were diagnosed as achlasia representing increased lower esophageal sphincter pressure and imcomplete relaxation during swallow, 2 as diffuse esopohageal spasm representing increased simultaneous contractions and absent peristatic contractions, and 28 as nonspecific esophageal motility disorders representing multiple esophageal motility abnormalities. Ten patients with esophageal cancer and 9 cardiac cancer showed local high pressure zone in the position of the lesion and peripheral esophageal body dismotility. Patients with diabetes mellitus decreased lower esophageal sphincter pressure and hypotensive esophageal body contractions. Conclusion: Esophageal manometry had great value in the diagnosis of primary and secondary esophageal motility disorders.