单纯反流性食管炎及合并滑动型食管裂孔疝的食管动力学研究

A STUDY ON ESOPHAGEAL KINETICS OF REFLUX ESOPHAGITIS WITH OR WITHOUT SLIDING HIATUS HERNIA

探讨滑动型食管裂孔疝合并反流性食管炎 (SHH组 )和单纯性反流性食管炎 (RE组 )患者的食管动力学特点。对经X线钡餐检查造影或胃镜证实的 5 0例SHH组和 5 0例RE组患者进行了食管动力和 2 4h食管pH监测。SHH组和RE组下食管括约肌长度 (LESL)为 (1 31± 0 33)cm和 (2 10± 0 86 )cm、下食管括约肌压力 (LESP)为 (1 17± 0 5 3)kPa和 (2 16± 0 6 5 )kPa ,SHH组均明显低于RE组 (P <0 0 5 )。两组反流参数均明显高于对照组 (P <0 0 1) ,SHH组除 pH <4时的反流次数其余指标均高于RE组 (P <0 0 5 )。提示SHH的食管抗反流功能比单纯RE患者明显低下 ,反流更严重 ;临床应对RE患者 ,特别是对可疑SHH患者应定期进行食管动力和 2 4h食管 pH监测。

To investigate the character of esophageal manometry in reflux esophagitis(RE) with or without sliding hiatus hernia(SHH). Ambulatory 24 hours esophageal pH metry and esophageal manometry were studied in 50 patients with RE, and 50 RE patients with SHH. Lower esophageal sphincter(LES) competence was significantly boorer in SHH groups as compared with RE group, esophageal sphincter length(LESL) was (1 31±0 33)cm in SHH groups and (2 10±0 86)cm in RE group, and lower esophageal sphincter pressure(LESP) was (1 17±0 53) kPa in SHH groups and (2 16±0 65) kPa in RE groups( P <0 05). All cases showed pathological gastroesophageal reflux. The reflux parameters, except when pH was greater than 4, were significantly greater in SHH group than in RE group ( P <0 05). SHH patients had worse esophageal antireflux competency. RE patients,being suspected to have SHH should receive routine esophageal manometic and pH examination.