食管动力检测对贲门失弛缓症诊断价值的探讨

Comparison of examination methods for achalasia

目的 :探讨早期诊断贲门失弛缓症的最佳方法。方法 :用食管动力测定 (食管下括约肌 (L ES)压力、松弛率、食管蠕动幅度 )、胃镜检查、食管钡剂造影分别对正常对照组与病例组进行检测。结果 :病例组 L ES压力 (4 .1± 0 .4 6 k Pa)较正常对照组高 ,有显著性差异 (P<0 .0 1)。病例组 L ES松弛率 (4 6± 6 .5 8% )较正常对照低 ,有显著性差异 (P<0 .0 1)。病例组食管蠕动幅度均值为 4 .6± 0 .4 6 k Pa较正常组低 ,有非常显著性差异 (P<0 .0 1) ,病例组食管体均为非推进性蠕动收缩 ;15例食管动力异常患者胃镜检查异常 4例 (2 7% ) ,钡剂造影异常者 8例 (5 3% )。结论

Objective:To evaluate different procedures for the diagnosis of achalasia Methods:Esophageal motility examination,gastroscopy and barium X ray were performed for the patients with suspect achalasia and the normal control subjects Results:The esophageal body in the patients with achalasia showed a nonpropulsive peristaltic contraction.Gastroscopic results in 4(27%) of 15 patients with abnormal esophageal manometry were abnormal,and barium X ray in 8 patients(53%) showed dilated esophagus and characteristic narrowing at gastroesophageal junction Conclusion:Esophageal manometry is essential for the diagnosis of achalasia