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难治性胃食管反流病病因研究 被引量:5
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作者 陈婕 许军英 《胃肠病学》 2001年第C00期5-5,共1页
目的:研究分析部分胃食管反流病(GERD)经临床常规抑酸治疗失败的原因。方法:16例经常规PPI抑酸治疗12周,临床症状或食管炎症未能控制的GERD患者(R组)及16例初诊为GERD的患者(P组),记录烧心、反酸等症状积分,内镜检查食管情况... 目的:研究分析部分胃食管反流病(GERD)经临床常规抑酸治疗失败的原因。方法:16例经常规PPI抑酸治疗12周,临床症状或食管炎症未能控制的GERD患者(R组)及16例初诊为GERD的患者(P组),记录烧心、反酸等症状积分,内镜检查食管情况,^14C-呼气试验检测Hp感染率,以便携式pH及胆反流监测仪24h同步监测食管下端pH及胆反流情况。结果:R组烧心等症状积分与P组差异无显著性,胃镜检查结果显示R组Barrett食管13例,其中3例合并食管溃疡,P组Barrett食管7例,其中1例合并食管溃疡,两组组差异有显著性。R组Hp检出率42%,与P组的71%差异有显著性;24h pH及胆反流监测结果显示:R组食管酸暴露时间与P组比较差异无显著性,胆红素吸收值≥0.14的总时间百分R组较P组显著升高,R组混合反流9例,与P组的5例差异有显著性,R组单纯胆反流4例,单纯酸反流2例,1例无病理性酸或胆反流,与P组单纯胆反流1例,单纯酸反流6例比较差异有显著性;各组酸和胆反流多同时发生,R组反流事件以夜间明显。结论:GERD合并严重食管炎,尤其是Barrett食管及出现并发症是GERD治疗困难的原因。 展开更多
关键词 难治性胃食管 病因 胆反流监测
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Assessment of duodenogastric reflux by combined continuous intragastric pH and bilirubin monitoring 被引量:30
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作者 Fei Dai Jun Gong Ru Zhang Jin-Yan Luo You-Ling Zhu Xue-Qin Wang,Department of Gastroenterology,Second Hospital of Xi’ an Jiaotong University,Xi’an 710004,Shaanxi Province,China 《World Journal of Gastroenterology》 SCIE CAS CSCD 2002年第2期382-384,共3页
AIM: To assess the diagnostic value of a combination of continuous intragastric pH and bilirubin monitoring in the detection of duodenogastric reflux (DGR), and the effects of diet on the bilirubin absorbance. METHODS... AIM: To assess the diagnostic value of a combination of continuous intragastric pH and bilirubin monitoring in the detection of duodenogastric reflux (DGR), and the effects of diet on the bilirubin absorbance. METHODS: 30 healthy volunteers were divided into two groups: standard diet group (Group 1) 18 cases, free diet group (Group 2)12 cases. Each subjects were subjected to simultaneous 24-hour intragastric pH and spectrophotometric bilirubin concentration monitoring (Bilitec 2000). RESULTS: There was no difference of preprandial phase bilirubin absorbance between two groups. The absorbance of postprandial phase was significantly increased in group 2 than group 1. There was no difference between preprandial phase and postprandial phase absorbance in group 1. Postprandial phase absorbance was significantly higher in group 2. In a comparison of bile reflux with intragastric pH during night time, there were 4 types of reflux: Simultaneous increase in absorbance and pH in only 19.6%, increase in bilirubin with unchanged pH 33.3%, pH increase with unchanged absorbance 36.3%, and both unchanged in 10.8%. Linear regression analysis showed no correlation between percentage total time of pH【4 and percentage total time of absorbance】0.14, r=0.068 P【0.05. CONCLUSION: Because of the dietary effect, high absorbance fluids or foods should be avoided in detection. Intragastric pH and bilirubin monitoring separately predict the presence of duodenal (and/or pancreatic) reflux and bile reflux. They can not substitute for each other. The detection of DGR is improved if the two parameters are combined simultaneously. 展开更多
关键词 ADULT Aged BILIRUBIN DIET Duodenogastric Reflux FEMALE Fiber Optics Humans Hydrogen-Ion Concentration Male Middle Aged Postprandial Period Random Allocation Research Support Non-U.S. Gov't
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