贲门松弛与酸反流间的关系

The correlation between dilated cardia and acid reflux

目的通过观察胃镜下贲门松弛的检出情况,研究胃镜下无症状性贲门松弛与酸反流之间的关系,探讨贲门松弛的临床意义。方法选取2015年1~6月在新疆维吾尔自治区人民医院行消化内镜检查判断为贲门松弛患者25例;临床表现均有不同程度上腹部不适或隐痛等消化不良症状,无明显的反流症状,如胃灼热、反酸等,所有患者同时进行24 h食管pH值监测。同期25例内镜检查无贲门松弛者作为对照组。结果两组患者食管24 h pH值监测值比较结果：病例组测酸各项指标较对照组高,但无显著统计学差异（P〉0.05）,以DeMeester〉14.72判断为病理性酸反流（p H＋）,病例组有4例pH＋,而对照组全部Ph（-）,两者差异有统计学意义（P〈0.05）。结论无症状贲门松弛者易于发生酸反流,临床上对于具有不典型反流症状且合并内镜下贲门松弛患者,行食管24小时pH监测可能有助于诊断。

Objective In clinically,many patients without Gastroesophageal reflux disease（ GERD）or hiatus hernia（ HH） have found a dilated cardia underwent endoscopy. Even the cardiac diameter reached 2 times the lens body or above. The main symptoms of these patients are abdominal discomfort or pain and dyspeptic symptoms. There are few reflux symptoms such as heartburn,acid reflux,etc. In this study,the detection of cardiac dilation was observed in the patients,To investigate the relationship between the symptoms and the acid reflux and the clinical significance of the cardiac dilation under endoscope.Methods Select 25 cases of patients from People＇ s Hospital of Xinjiang Uygur Autonomous Region who have cardiac dilation under endoscopy from January 2015 to June 2015; They have different degrees of abdominal discomfort or pain and dyspeptic symptoms,rarely have reflux symptoms such as heartburn,acid reflux obviously,etc. All patients were examined at the same time for 24 hours PH. At the same time 25 cases of endoscopic examination without cardiac dilation as the control group. Results compare the results of 24 hours of p H value of the level between two groups. Between the two groups were measured indicators of acid was higher than that in control group,But there was no significant difference between the two groups（ P〉 0. 05）. The pathological acid reflux（ pH ＋） was judged by De Meester〉 14. 72. The case group consisted of 4 patients with pH ＋,while all control group was Ph（-）. There was a significant difference between the two groups（ P〈0. 05）. Conclusion Asymptomatic cardiac and cardiac dilation are prone to acid reflux,clinical symptoms and atypical reflux symptoms,and combined with endoscopic cardiac dilation,esophageal 24 hours pH monitoring may be helpful for diagnosis.