Objective To retrospectively review the experience of esophageal manometry and 24-hour pH monitoring in e-sophagus surgery. Methods From 1982 to 2010,patients with unspecific chest pain and undergone esophageal surger...Objective To retrospectively review the experience of esophageal manometry and 24-hour pH monitoring in e-sophagus surgery. Methods From 1982 to 2010,patients with unspecific chest pain and undergone esophageal surgery were received esophageal manometry and 24-hour pH monitoring. Results Among the patients with展开更多
AIM: To determine the gastroesophageal refl uxate in the cervical esophagus (CE) and measure transcutaneous cervical esophageal ultrasound (TCEUS) f indings [anterior wall thickness (WT) of CE, esophageal luminal diam...AIM: To determine the gastroesophageal refl uxate in the cervical esophagus (CE) and measure transcutaneous cervical esophageal ultrasound (TCEUS) f indings [anterior wall thickness (WT) of CE, esophageal luminal diameter (ELD), esophageal diameter (ED)]; to compare TCEUS findings in the patient subgroups divided according to 24-h esophageal pH monitoring and manometry; and to investigate possible cut-off values according to the TCEUS f indings as a predictor of gastroesophageal refl ux (GER). METHODS: In 45/500 patients, refl uxate was visualized in TCEUS. 38/45 patients underwent esophagogastroduo denoscopy (EGD), 24-h pH monitoring and manometry. RESULTS: The 38 patients were grouped according to 24-h pH monitoring as follows: Group A: GER-positive (n = 20) [Includes Group B: isolated proximal refl ux (PR) (n = 6), Group C: isolated distal reflux (DR) (n = 6), and Group D: both PR/DR (n = 8)]; Group E: no refl ux (n = 13); and Group F: hypersensitive esophagus (HSE) (n = 5). Groups B + D indicated total PR patients (n = 14), Groups E + F refl ux-negatives with HSE (n = 18), and Groups A + F refl ux-positives with HSE (n = 25). When the 38 patients were grouped according to manometry fi ndings, 24 had normal esophageal manometry; 7 had hypotensive and 2 had hypertensive lower esophageal sphincter (LES); and 5 had ineffective esophageal motility disorder (IEM). The ELD measurement was greater in group A + F than group E (P = 0.023, 5.0 ± 1.3 vs 3.9 ± 1.4 mm). In 27/38 patients, there was at least one pathologic acid refl ux and/or pathologic manometry fi nding. The cut-off value for ELD of 4.83 mm had 79% sensitivity and 61% specificity in predicting the PRbetween Groups B + D and E (AUC = 0.775, P = 0.015). CONCLUSION: Visualizing refluxate in TCEUS was useful as a pre-diagnostic tool for estimating GER or manometric pathology in 71.1% of adults in our study, but it was not diagnostic for CE WT.展开更多
Introduction: Delayed gastric emptying (DGE) often occurs in patients with gastroesophageal reflux (GER) due to neurological impairment (NI). 13C has been used as an alternative tool for measuring the gastric emptying...Introduction: Delayed gastric emptying (DGE) often occurs in patients with gastroesophageal reflux (GER) due to neurological impairment (NI). 13C has been used as an alternative tool for measuring the gastric emptying rates. The aim of this study was to predict gastric emptying in children with GER using 13C-acetate breath test (ABT) by 24-hour pH monitoring. Methods: Nineteen patients were divided into 2 groups: a DGE group with NI (14 patients), and normal-emptying group without NI (5 patients). The liquid test meal consisted of RacolTM (5 ml/kg) mixed with 13C-acetate (50 mg for infants, 100 mg for children, and 150 mg for adolescents). 13CO2 was measured using a gas chromatograph-isotope ratio mass spectrometer. The results are expressed as the % of 13C expired per hour and cumulative 13C excretion over a 3-hour periods including the parameters of half excretion and lag time. Results: The mean half excretion time was 1.762 hour in the DGE group and 1.095 hour in the normal-emptying group (P = 0.0196). The mean lag time was 0.971 hour in the DGE group and 0.666 hour in the normal-emptying group (P = 0.0196). Therefore, DGE was significantly more prevalent in the DGE compared to the normal-emptying group. The percentage of the time when the pH was less than 4 on 24-hour esophageal pH monitoring was 21.6% ± 9.2% in the DGE group and 28.5% ± 11.6% in the normal-emptying group (P = 0.4634). Conclusion: The percentage of time when the pH is less than 4 on 24-hour pH monitoring cannot predict DGE measured by the 13C-ABT in GER.展开更多
目的探讨食管测压联合食管24 h pH监测对胃食管反流相关性胸痛的诊断价值。方法选取通辽市医院2017年6月至2021年12月接收的疑似胃食管反流引起的相关性胸痛患者145例,男92例,女53例,采用食管测压联合食管24 h pH进行监测,以是否胃食管...目的探讨食管测压联合食管24 h pH监测对胃食管反流相关性胸痛的诊断价值。方法选取通辽市医院2017年6月至2021年12月接收的疑似胃食管反流引起的相关性胸痛患者145例,男92例,女53例,采用食管测压联合食管24 h pH进行监测,以是否胃食管反流分为胃食管反流组与无反流组。收集两组患者的年龄、性别、蠕动收缩百分数、pH<4反流次数、最长反流持续时间等资料,采用t、χ2检验进行统计比较,通过多因素logistic回归分析、受试者工作特征曲线(ROC)分析上述指标与胃食管反流相关性胸痛的相关性。结果145例疑似胃食管反流相关性胸痛患者,经诊断为胃食管返流36例,无返流109例。经多因素logistic回归分析发现,蠕动收缩百分数、pH<4反流次数、最长反流持续时间均是胃食管反流引起的相关性胸痛的影响因素[比值比(OR)=3.155、2.998、3.459,P=0.003、0.012、0.001]。经ROC分析,食管测压、pH<4反流次数、最长反流持续时间联合预测胃食管反流引起的相关性胸痛的灵敏度与曲线下面积(AUC)均高于各指标单独预测时(P=0.001、0.001、0.004),联合预测的特异度与各指标单独预测时差异无统计学意义(P=0.852)。结论食管测压联合食管24 h pH监测对于胃食管反流引起的相关性胸痛的诊断、治疗具有重要意义,值得临床推广应用。展开更多
目的探讨多通道阻抗联合24 h pH监测在胃食管反流病(gastroesophageal reflux disease,GERD),尤其在pH(-)GERD患者中的应用价值。方法 48例GERD患者应用多通道阻抗联合24 h pH监测,根据Demeester评分分为pH(-)与pH(+),其中pH(-)GERD 30...目的探讨多通道阻抗联合24 h pH监测在胃食管反流病(gastroesophageal reflux disease,GERD),尤其在pH(-)GERD患者中的应用价值。方法 48例GERD患者应用多通道阻抗联合24 h pH监测,根据Demeester评分分为pH(-)与pH(+),其中pH(-)GERD 30例,pH(+)GERD 18例;另相同监测健康大学生志愿者20例做正常对照组。结果 GERD组酸反流次数、卧位食团暴露时间及总食团暴露时间均高于正常对照组,差别有统计学意义(P=0.01,P=0.002,P=0.03);GERD组非酸反流次数低于正常对照组,差别有统计学意义(P=0.002)。pH(-)GERD组卧位食团暴露时间高于正常对照组(P=0.015),pH(-)GERD酸反流次数及卧位食团暴露时间均低于pH(+)GERD,差别有统计学意义(P=0.02,P=0.04)。结论多通道阻抗联合24 h pH监测能发现更多的反流事件,在GERD尤其对pH(-)GERD患者的诊断有实用意义,需进一步研究。展开更多
目的探讨老年人食管酸暴露情况并与其他人群进行对照比较,以了解老年人食管酸反流的特点及其临床意义。方法采用便携式24 h pH动态监测仪对31例老年人进行食管24 h pH监测,并与40例其他人群进行对照比较。结果老年人组24 h食管酸暴露的6...目的探讨老年人食管酸暴露情况并与其他人群进行对照比较,以了解老年人食管酸反流的特点及其临床意义。方法采用便携式24 h pH动态监测仪对31例老年人进行食管24 h pH监测,并与40例其他人群进行对照比较。结果老年人组24 h食管酸暴露的6项pH指标中有4项与对照组差异有统计学意义(P<0.05)。95%分布范围中,立位pH<4的总时间(%)和pH<4的反流次数的指标两组较为接近,余4项指标老年组数值均高于对照组。总计分老年组为14.9,高于对照组(12.7)。结论老年人组食管酸暴露多项指标高于对照组,提示可能与老年人食管运动功能和清除酸的能力下降以及食管下端括约肌(LES)功能较年轻人减弱有关。展开更多
In order to examine the severity of reflux esophagitis and the methods of manometry and 24 hour ambulatory pHmonitoring, 100 gastroesophageal reflux disease (GERD) patients were examined. The results were compared wit...In order to examine the severity of reflux esophagitis and the methods of manometry and 24 hour ambulatory pHmonitoring, 100 gastroesophageal reflux disease (GERD) patients were examined. The results were compared with acontrol group which consisted of 30 healthy individuals. Endoscopy was performed, and esophageal mucosa biopsieswere taken in all patients. Esophageal manometry was recorded using a four tune water perfused system. The severi-ty of esophagitis, determined by both endoscopy and histology, was related to the amplitude of esophageal perista1ticwaves, in partictilar the cardioesophageal sphincter (CES) dysfunction (P < 0. 01), 24 hour reflux total score. Wehave concluded that the severity of reflux esophagitis is related to the duration of reflux, which in turn is associatedwith the impairment of esophageal body motility and CES dysfunction.展开更多
文摘Objective To retrospectively review the experience of esophageal manometry and 24-hour pH monitoring in e-sophagus surgery. Methods From 1982 to 2010,patients with unspecific chest pain and undergone esophageal surgery were received esophageal manometry and 24-hour pH monitoring. Results Among the patients with
文摘AIM: To determine the gastroesophageal refl uxate in the cervical esophagus (CE) and measure transcutaneous cervical esophageal ultrasound (TCEUS) f indings [anterior wall thickness (WT) of CE, esophageal luminal diameter (ELD), esophageal diameter (ED)]; to compare TCEUS findings in the patient subgroups divided according to 24-h esophageal pH monitoring and manometry; and to investigate possible cut-off values according to the TCEUS f indings as a predictor of gastroesophageal refl ux (GER). METHODS: In 45/500 patients, refl uxate was visualized in TCEUS. 38/45 patients underwent esophagogastroduo denoscopy (EGD), 24-h pH monitoring and manometry. RESULTS: The 38 patients were grouped according to 24-h pH monitoring as follows: Group A: GER-positive (n = 20) [Includes Group B: isolated proximal refl ux (PR) (n = 6), Group C: isolated distal reflux (DR) (n = 6), and Group D: both PR/DR (n = 8)]; Group E: no refl ux (n = 13); and Group F: hypersensitive esophagus (HSE) (n = 5). Groups B + D indicated total PR patients (n = 14), Groups E + F refl ux-negatives with HSE (n = 18), and Groups A + F refl ux-positives with HSE (n = 25). When the 38 patients were grouped according to manometry fi ndings, 24 had normal esophageal manometry; 7 had hypotensive and 2 had hypertensive lower esophageal sphincter (LES); and 5 had ineffective esophageal motility disorder (IEM). The ELD measurement was greater in group A + F than group E (P = 0.023, 5.0 ± 1.3 vs 3.9 ± 1.4 mm). In 27/38 patients, there was at least one pathologic acid refl ux and/or pathologic manometry fi nding. The cut-off value for ELD of 4.83 mm had 79% sensitivity and 61% specificity in predicting the PRbetween Groups B + D and E (AUC = 0.775, P = 0.015). CONCLUSION: Visualizing refluxate in TCEUS was useful as a pre-diagnostic tool for estimating GER or manometric pathology in 71.1% of adults in our study, but it was not diagnostic for CE WT.
文摘Introduction: Delayed gastric emptying (DGE) often occurs in patients with gastroesophageal reflux (GER) due to neurological impairment (NI). 13C has been used as an alternative tool for measuring the gastric emptying rates. The aim of this study was to predict gastric emptying in children with GER using 13C-acetate breath test (ABT) by 24-hour pH monitoring. Methods: Nineteen patients were divided into 2 groups: a DGE group with NI (14 patients), and normal-emptying group without NI (5 patients). The liquid test meal consisted of RacolTM (5 ml/kg) mixed with 13C-acetate (50 mg for infants, 100 mg for children, and 150 mg for adolescents). 13CO2 was measured using a gas chromatograph-isotope ratio mass spectrometer. The results are expressed as the % of 13C expired per hour and cumulative 13C excretion over a 3-hour periods including the parameters of half excretion and lag time. Results: The mean half excretion time was 1.762 hour in the DGE group and 1.095 hour in the normal-emptying group (P = 0.0196). The mean lag time was 0.971 hour in the DGE group and 0.666 hour in the normal-emptying group (P = 0.0196). Therefore, DGE was significantly more prevalent in the DGE compared to the normal-emptying group. The percentage of the time when the pH was less than 4 on 24-hour esophageal pH monitoring was 21.6% ± 9.2% in the DGE group and 28.5% ± 11.6% in the normal-emptying group (P = 0.4634). Conclusion: The percentage of time when the pH is less than 4 on 24-hour pH monitoring cannot predict DGE measured by the 13C-ABT in GER.
文摘目的探讨食管测压联合食管24 h pH监测对胃食管反流相关性胸痛的诊断价值。方法选取通辽市医院2017年6月至2021年12月接收的疑似胃食管反流引起的相关性胸痛患者145例,男92例,女53例,采用食管测压联合食管24 h pH进行监测,以是否胃食管反流分为胃食管反流组与无反流组。收集两组患者的年龄、性别、蠕动收缩百分数、pH<4反流次数、最长反流持续时间等资料,采用t、χ2检验进行统计比较,通过多因素logistic回归分析、受试者工作特征曲线(ROC)分析上述指标与胃食管反流相关性胸痛的相关性。结果145例疑似胃食管反流相关性胸痛患者,经诊断为胃食管返流36例,无返流109例。经多因素logistic回归分析发现,蠕动收缩百分数、pH<4反流次数、最长反流持续时间均是胃食管反流引起的相关性胸痛的影响因素[比值比(OR)=3.155、2.998、3.459,P=0.003、0.012、0.001]。经ROC分析,食管测压、pH<4反流次数、最长反流持续时间联合预测胃食管反流引起的相关性胸痛的灵敏度与曲线下面积(AUC)均高于各指标单独预测时(P=0.001、0.001、0.004),联合预测的特异度与各指标单独预测时差异无统计学意义(P=0.852)。结论食管测压联合食管24 h pH监测对于胃食管反流引起的相关性胸痛的诊断、治疗具有重要意义,值得临床推广应用。
文摘目的探讨多通道阻抗联合24 h pH监测在胃食管反流病(gastroesophageal reflux disease,GERD),尤其在pH(-)GERD患者中的应用价值。方法 48例GERD患者应用多通道阻抗联合24 h pH监测,根据Demeester评分分为pH(-)与pH(+),其中pH(-)GERD 30例,pH(+)GERD 18例;另相同监测健康大学生志愿者20例做正常对照组。结果 GERD组酸反流次数、卧位食团暴露时间及总食团暴露时间均高于正常对照组,差别有统计学意义(P=0.01,P=0.002,P=0.03);GERD组非酸反流次数低于正常对照组,差别有统计学意义(P=0.002)。pH(-)GERD组卧位食团暴露时间高于正常对照组(P=0.015),pH(-)GERD酸反流次数及卧位食团暴露时间均低于pH(+)GERD,差别有统计学意义(P=0.02,P=0.04)。结论多通道阻抗联合24 h pH监测能发现更多的反流事件,在GERD尤其对pH(-)GERD患者的诊断有实用意义,需进一步研究。
文摘目的探讨老年人食管酸暴露情况并与其他人群进行对照比较,以了解老年人食管酸反流的特点及其临床意义。方法采用便携式24 h pH动态监测仪对31例老年人进行食管24 h pH监测,并与40例其他人群进行对照比较。结果老年人组24 h食管酸暴露的6项pH指标中有4项与对照组差异有统计学意义(P<0.05)。95%分布范围中,立位pH<4的总时间(%)和pH<4的反流次数的指标两组较为接近,余4项指标老年组数值均高于对照组。总计分老年组为14.9,高于对照组(12.7)。结论老年人组食管酸暴露多项指标高于对照组,提示可能与老年人食管运动功能和清除酸的能力下降以及食管下端括约肌(LES)功能较年轻人减弱有关。
文摘In order to examine the severity of reflux esophagitis and the methods of manometry and 24 hour ambulatory pHmonitoring, 100 gastroesophageal reflux disease (GERD) patients were examined. The results were compared with acontrol group which consisted of 30 healthy individuals. Endoscopy was performed, and esophageal mucosa biopsieswere taken in all patients. Esophageal manometry was recorded using a four tune water perfused system. The severi-ty of esophagitis, determined by both endoscopy and histology, was related to the amplitude of esophageal perista1ticwaves, in partictilar the cardioesophageal sphincter (CES) dysfunction (P < 0. 01), 24 hour reflux total score. Wehave concluded that the severity of reflux esophagitis is related to the duration of reflux, which in turn is associatedwith the impairment of esophageal body motility and CES dysfunction.
