高分辨率食管测压法在食管裂孔疝诊断中的意义

Significance of High-resolution Esophageal Manometry in the Diagnosis of Hiatal Hernia

目的分析高分辨率食管测压法在食管裂孔疝诊断中的意义。方法方便选取该院2017年8月—2019年11月食管裂孔疝的患者65例,患者均进行胃镜检查及高分辨率食管测压,观察诊断结果,方便选取同期非食管裂孔疝患者65例,观察食管测压结果及24 h食管pH检测结果。结果 65例食管裂孔疝患者经高分辨率食管测压法检出62例,准确率95.38%,胃镜检查检出53例,准确率81.54%,差异有统计学意义(χ^2=6.104,P<0.05);两组食管下括约肌长度对比,差异有统计学意义(t=0.531,P>0.05),食管裂孔疝组呼吸最小值(0.73±0.23)kPa,呼吸平均值(1.40±0.57)kPa,低于非食管裂孔疝组,差异有统计学意义(t=9.258、7.659,P<0.05);食管裂孔疝组pH≤4的总次数(130.27±52.47)次,反流时间≥5 min的次数(10.28±3.78)次,最长反流时间(55.39±21.37)min,DeMeester评分(73.29±30.27)分,酸性反流指数(20.74±8.32),与非食管裂孔疝组相比,差异有统计学意义(t=11.174、11.621、10.983、13.237、14.322,P<0.05)。结论在食管裂孔疝诊断中,高分辨率食管测压法具有较高的诊断价值,能有效提高食管裂孔疝诊断准确率,为疾病的诊断提供依据,值得借鉴。

Objective To analyze the significance of high-resolution esophageal manometry in the diagnosis of hiatal hernia.Methods From August 2017 to November 2019, 65 patients with hiatal hernia in the hospital were convenient selected. All patients underwent gastroscopy and high-resolution esophageal pressure measurement. The diagnosis results were observed.65 patients with non-esophageal hiatal hernia during the same period were selected for observation. Esophageal pressure test results and 24 h esophageal pH test results were observed. Results 65 cases of hiatal hernia were detected by highresolution esophageal manometry in 62 cases, the accuracy rate was 95.38%, 53 cases were detected by gastroscopy, the accuracy rate was 81.54%, the difference was statistically significant(χ^2=6.104,P<0.05);the length of the lower esophageal sphincter in the two groups, the difference was statistically significant(t=0.531,P>0.05), the minimum respiration value of the hiatal hernia group was(0.73±0.23)kPa, and the average value of respiration(1.40±0.57) k Pa, which was lower than that of the non-hiatal hernia group, the minimum value of respiration and the average value of respiration, the difference was statistically significant(t=9.258,7.659,P<0.05);the total number of esophageal hiatal hernia group pH≤4(130.27±52.47)times, reflux time ≥5 min(10.28±3.78) times, the longest reflux time(55.39±21.37) min, DeMeester score(73.29±30.27)points, acid reflux index(20.74±8.32), compared with the non-esophageal hiatal hernia group, the total number of times with tpH value ≤ 4, the number of times with reflux time ≥ 5 min, the longest reflux index flow time, DeMeester score, acid reflux index, the difference was statistically significant(t=11.174,11.621,10.986,13.237,14.322,P<0.05). Conclusion In the diagnosis of esophageal hiatal hernia, high-resolution esophageal manometry has a high diagnostic value, which can effectively improve the diagnostic accuracy of esophageal hiatal hernia and provide a basis for the diagnosis of the disease,which is worth learning.