咽异感症的高分辨率食管测压特点分析

Analysis of the characteristic of pharyngeal paraesthesia patients by high resolution manometry

目的:探讨咽异感症患者上食管括约肌(UES)、下食管括约肌(LES)的压力变化及食管动力学特点。方法:对44例咽异感症患者和23例正常人(正常对照组)分别进行高分辨率食管压力测定。根据RSI评分将44例咽异感症患者分为A组(无反流组,RSI<13分,25例)和B组(反流组,RSI≥13分,19例)。结果:A、B组UES平均静息压及平均残余压力均高于正常对照组(P<0.05);B组UES平均静息压及平均残余压力高于A组(P<0.05);B组LES平均静息压及平均残余压力均低于A组及正常对照组(P<0.05),A组与正常对照组间LES平均静息压及平均残余压力差异无统计学意义(P>0.05)。B组食管远端收缩积分低于A组及正常对照组(P<0.05),A组与正常对照组间食管远端收缩积分差异无统计学意义(P>0.05)。结论:咽异感症患者咽异感症状与UES压力增高相关,反流组患者咽异感症状与LES低压和UES高压相关。反流组患者的食管末部动力障碍,其蠕动力度减弱,清除食团及胃内反流物的能力下降。

Objective：To discuss the pressure changing characteristics of upper esophageal sphincter（UES）, lower esophageal sphincter （LES） and the esophagus kinetic characteristics of pharyngeal paraesthesia patients. Method：To take high resolution manometry in 44 cases of pharyngeal paraesthesia patients and 23 normal subjects separately. According to the RSI score, the 44 patients were divided into group A（the group without reflux,RSI〈 13,n=25） and group B （the group with reflux,RSI≥13,n=19）. Result：The UES average resting pressure and average residual pressure of patients group were higher than the control group （P〈0.05） ; The UES average rest- ing pressure and average residual pressure of group B were higher than group A （P〈0.05） ;The LES average resting pressure and average residual pressure of group B were lower than group A and the control group （P〈0.05） ;The comparison of LES average resting pressure and average residual pressure between group A and the control group was not statistically significant （P〉0.05）. The esophagus DCI of group B was lower than that of group A and control group （P〈0.05）. The esophagus DCI comparison between group A and control group was not statistically significant （P〉0.05）. Conclusion：The pharyngeal paresthesia symptoms of patients was associat- ed with the increasing of UES pressure. The pharyngeal paresthesia symptoms of group with reflux was related to low pressure of LES and high pressure of UES. The last part of esophagus of group with reflux had obstacles in powers, which weaken the peristalsis and declined the ability to clear the bolus and gastric reflux material .