食管功能检查的临床应用

Clinical application of esophageal manometry and 24 hour esophageal pH monitoring

目的探讨食管腔内压力测定和２４小时食管ｐＨ监测在临床的应用价值。方法用上述食管功能检查方法对：（１）胃食管反流性疾病采用内、外科不同治疗方法的比较；（２）鉴别食管源性胸痛；（３）评价抗酸药物的作用；以及（４）胆囊切除术后胃食管功能监测等。结果通过食管功能检查完成了对上述四项内容的验证和评价，取得了良好的效果。结论食管腔内压力测定和２４小时食管ｐＨ监测是诊断食管功能性疾病最敏感和特异的检查方法，它可以获取许多放射学、内镜及其它检查方法难以得到的资料。

Objective To evaluate the clinical application of esophageal manometry and 24 hour esophageal pH monitoring. Methods From 1990 to 1996,ambulatory esophageal manometry and 24 hour esophageal pH monitoring were performed on 101 patients with different functional esophageal diseases,including Barrett′s esophagus 54 patients non cardiac chest pain (10) and post cholecystectomy (37).Esophageal motility studies were made to compare the effects of different anti reflux therapies,to identify primary esophageal motility disorders,to assess the effect of anti acid drugs,and to study the relationship between esophageal motility disorder and other non esophageal origin disease. Results In this study,anti reflux surgery was better than medical therapy in controlling gastroesophageal reflux (GER) for Barrett′s esophagus.Esophageal manometry was the best method for detecting primary esophageal motility disease.Omeprazole was superior to cimetidine in terms of control of GER and reduction of gastric acidity.Cholecystectomy resulted in GER and many symptoms after surgery appered to have an esophageal origin. Conclusions Esophageal manometry and 24 hour esophageal pH monitoring are the most sensitive and specialized methods for detecting esophageal motility disorders.They are superior to other routine diagnostic methods such as radiology and endoscopy.