嗳气症患者24h多通道食管阻抗-pH监测的临床研究

Clinical Study on the 24-hour Esophageal Multichannel Intraluminal Impedance-pH Monitoring in Patients with Belching

目的嗳气症患者进行24h多通道食管阻抗-pH监测,观察不同亚型嗳气症患者的监测结果,探究不同亚型嗳气症患者的胃食管反流模式,评估该技术在嗳气症中的临床价值。方法根据罗马Ⅲ的定义,将115例嗳气症患者分为吞气症(组Ⅰ)39例和非特异性过度嗳气(组Ⅱ)76例。所有患者进行24h多通道食管阻抗-pH监测,观察不同亚型嗳气症患者的反流物性状、反流类型及嗳气类型。结果两组患者在年龄、性别方面无明显差异,且总反流次数、反流物性状和反流类型在两组间差异无统计学意义。组Ⅰ胃内型嗳气较非特异性过度嗳气(组Ⅱ)明显减少(P<0.001),胃上型嗳气则明显增多(P=0.008)。结论不同亚型嗳气症患者的发生机制不同,需进行个体化治疗。24h多通道食管阻抗-pH监测是评估嗳气症患者的重要诊疗手段。

Objective To observe the results of 24-hour esophageal multichannel intraluminal impedance-pH monitoring in belching patients with different subtypes, explore the gastroesophageal reflux pattern, and evaluate the clinical value of the monitoring technique in belching disease. Methods 115 patients with belching were divided into the aerophagia group （group I, 39 cases） and nonspecific excessive belching （group II, 76 cases）. All patients received the 24-hour esophageal multichannel intraluminal impedance-pH monitoring. The reflux components＇ characters, reflux types and belching type were observed. Results There were no statistical differences in gender and age, total reflux frequency, reflux components＇ characters and reflux types between two groups. Gastric retained belching was significantly less than the nonspecific excessive belching in group I （P 0.001）, while supra-gastric belching increased obviously in group I （P = 0.008）. Conclusions The mechanisms are different in belching with different subtypes, and individual treatments should be taken. 24-hour esophageal multichannel intraluminal impedance-pH monitoring is an important diagnosis and treatment method for evaluating patients with belching.