Background. We assessed the characteristics of symptomatic gastroesophageal reflux disease (sGERD), defined as the presence of symptoms, but no endoscopic findings of reflux esophagitis, in Japanese. Methods. Sixty- t...Background. We assessed the characteristics of symptomatic gastroesophageal reflux disease (sGERD), defined as the presence of symptoms, but no endoscopic findings of reflux esophagitis, in Japanese. Methods. Sixty- three patients were diagnosed with sGERD, and underwent 24- h esophagogastric pH monitoring (32 men; mean age, 50.5 years). Patients were classified into the following three groups: reflux group (group R), minor reflux group (group MR), and a no- reflux group (group N) by the percentage of time at pH below 4 (group R, 4.0% or more; group MR, 2.0% - 3.9% ;groupN, 0- 1.9% ). Hiatal hernia was assessed based on the Anatomy- Function- Pathology (AFP) classification, and the shape of the cardia was assessed based on valve factors (V0- V3). Results. There were 13 patients (21% ) in group R, 17 (27% ) in group MR, and 33 (52% ) in group N.Hiatal hernia was present in 11 patients (85% ) in group R, 14 (82% ) in group MR, and 22 (67% ) in group N. Patients grouped according to presence of V2/V3 (chalasia) accounted for 100% of those in group R, 71% of those in group MR and 70% of those in group N. Hiatal hernia was present in 10 (91% ), 10 (83% ), and 6 patients (86% ) who had 50 or more episodes of esophageal acid reflux per day in group R, group MR, and group N, respectively. Conclusions. Reflux (percentage of time below pH 4, 4% ) was seen in only about 20% of the patients with sGERD, and this percentage of patients with reflux was lower compared to the data reported from the United States and Europe. The percentage of patients who had a hiatal hernia or chalasia was high in all these groups, and this seemed to be a characteristic cause of sGERD in Japanese.展开更多
目的本文研究了Hp阴性和Hp阳性的胃食管反流病(GERD)患者食管动力学和食管酸暴露情况,以阐明Hp感染和GERD两者之间的关系。方法纳入GERD患者64例,按Hp感染情况分为Hp阳性组37例,Hp阴性组27例。检测前1周停用抑酸药和胃肠动力药。对2组...目的本文研究了Hp阴性和Hp阳性的胃食管反流病(GERD)患者食管动力学和食管酸暴露情况,以阐明Hp感染和GERD两者之间的关系。方法纳入GERD患者64例,按Hp感染情况分为Hp阳性组37例,Hp阴性组27例。检测前1周停用抑酸药和胃肠动力药。对2组进行食管动力学检测和食管24 h pH监测。结果①Hp阳性和Hp阴性组性别、年龄和体质量指数无显著性差异(P>0.05)。②Hp阳性和Hp阴性组食管动力学检测:LES压力、长度及食管体部的各项动力学指标均无显著差异(P>0.05)。③Hp阳性和Hp阴性组24 h食管pH监测DeMeester评分、食管pH<4时间百分比、pH<4反流次数、pH<4大于5min反流次数、pH<4最长反流持续时间均无显著性差异(P>0.05)。④本研究中GERD患者食管下端括约肌压力(LESP)为(9.1±1.9)mm Hg,明显低于正常人,但它和DeMeester评分无相关性(r=0.130,P=0.304)。结论①Hp感染对胃食管反流病患者的LESP和食管体部的运动功能无明显影响;②Hp感染对胃食管反流病患者的食管酸暴露也没有显著影响;③Hp感染与胃食管反流病的发生没有明显关系。展开更多
目的评价综合抗反流术式在贲门外科临床应用的效果。方法将33例贲门癌患者食管胃吻合术中采用综合抗反流术者作为A组,另选取临床资料相仿,但未行综合抗反流术的8例贲门癌手术患者作为B组对照,通过手术前后食管胃腔内测压以及24 h pH值...目的评价综合抗反流术式在贲门外科临床应用的效果。方法将33例贲门癌患者食管胃吻合术中采用综合抗反流术者作为A组,另选取临床资料相仿,但未行综合抗反流术的8例贲门癌手术患者作为B组对照,通过手术前后食管胃腔内测压以及24 h pH值测定评价抗反流效果。结果A组术后食管体部出现新的高压区,其pH<4的总时间(%)、pH<4的反流次数、>5 min的反流次数各项指标均较B组明显减少(P<0.01)。结论综合抗反流术式方法简便,临床抗反流效果好,值得在贲门外科中推广应用。展开更多
目的分析难治性胃食管反流(GERD)相关疾病食管动力特点及功能,并探讨不同吞咽试验对食管动力障碍的检出情况。方法选取遵义医学院附属医院2016年2月—2018年2月收治的难治性GERD患者40例,根据疾病类型分为反流性食管炎(RE)11例、非糜烂...目的分析难治性胃食管反流(GERD)相关疾病食管动力特点及功能,并探讨不同吞咽试验对食管动力障碍的检出情况。方法选取遵义医学院附属医院2016年2月—2018年2月收治的难治性GERD患者40例,根据疾病类型分为反流性食管炎(RE)11例、非糜烂性反流(NERD)组17例和症状-反流无关联组12例。患者均进行胃镜检查、24 h pH联合阻抗监测、高分辨率食管测压。比较3组患者胃食管反流症状及食管动力特点(酸暴露时间、酸反流次数、非酸反流次数);比较3组患者食管动力功能指标[食管插约面(LES)长度、腹腔内LES长度、常规吞咽蠕动率、LES静息压、连续性饮水吞咽次数、连续性饮水吞咽花费时间、食管有效收缩率、LES收缩率]、食管动力障碍检出情况。结果 3组患者反流性疾病问卷(RDQ)积分及非酸反流次数比较,差异无统计学意义(P>0.05);NERD组、症状-反流无关联组酸暴露时间短于RE组,酸反流次数少于RE组(P<0.05)。3组患者LES长度,腹腔内LES长度、常规吞咽蠕动率、LES静息压、连续饮水吞咽次数及连续饮水吞咽花费时间比较,差异无统计学意义(P>0.05);NERD组、症状-反流无关联组食管有效收缩率、LES收缩率高于RE组(P<0.05)。3组患者常规吞咽试验、固体吞咽试验食管动力障碍检出率比较,差异无统计学意义(P>0.05)。结论 GERD患者中RE、NERD和症状-反流无关联患者胃食管反流症状相似,非酸反流次数相当,但NERD和症状-反流无关联患者的酸暴露时间短、酸反流次数少,食管有效收缩率、LES收缩率高,食管动力功能较强,且不同吞咽试验对食管动力障碍检出情况相当。展开更多
文摘Background. We assessed the characteristics of symptomatic gastroesophageal reflux disease (sGERD), defined as the presence of symptoms, but no endoscopic findings of reflux esophagitis, in Japanese. Methods. Sixty- three patients were diagnosed with sGERD, and underwent 24- h esophagogastric pH monitoring (32 men; mean age, 50.5 years). Patients were classified into the following three groups: reflux group (group R), minor reflux group (group MR), and a no- reflux group (group N) by the percentage of time at pH below 4 (group R, 4.0% or more; group MR, 2.0% - 3.9% ;groupN, 0- 1.9% ). Hiatal hernia was assessed based on the Anatomy- Function- Pathology (AFP) classification, and the shape of the cardia was assessed based on valve factors (V0- V3). Results. There were 13 patients (21% ) in group R, 17 (27% ) in group MR, and 33 (52% ) in group N.Hiatal hernia was present in 11 patients (85% ) in group R, 14 (82% ) in group MR, and 22 (67% ) in group N. Patients grouped according to presence of V2/V3 (chalasia) accounted for 100% of those in group R, 71% of those in group MR and 70% of those in group N. Hiatal hernia was present in 10 (91% ), 10 (83% ), and 6 patients (86% ) who had 50 or more episodes of esophageal acid reflux per day in group R, group MR, and group N, respectively. Conclusions. Reflux (percentage of time below pH 4, 4% ) was seen in only about 20% of the patients with sGERD, and this percentage of patients with reflux was lower compared to the data reported from the United States and Europe. The percentage of patients who had a hiatal hernia or chalasia was high in all these groups, and this seemed to be a characteristic cause of sGERD in Japanese.
文摘目的本文研究了Hp阴性和Hp阳性的胃食管反流病(GERD)患者食管动力学和食管酸暴露情况,以阐明Hp感染和GERD两者之间的关系。方法纳入GERD患者64例,按Hp感染情况分为Hp阳性组37例,Hp阴性组27例。检测前1周停用抑酸药和胃肠动力药。对2组进行食管动力学检测和食管24 h pH监测。结果①Hp阳性和Hp阴性组性别、年龄和体质量指数无显著性差异(P>0.05)。②Hp阳性和Hp阴性组食管动力学检测:LES压力、长度及食管体部的各项动力学指标均无显著差异(P>0.05)。③Hp阳性和Hp阴性组24 h食管pH监测DeMeester评分、食管pH<4时间百分比、pH<4反流次数、pH<4大于5min反流次数、pH<4最长反流持续时间均无显著性差异(P>0.05)。④本研究中GERD患者食管下端括约肌压力(LESP)为(9.1±1.9)mm Hg,明显低于正常人,但它和DeMeester评分无相关性(r=0.130,P=0.304)。结论①Hp感染对胃食管反流病患者的LESP和食管体部的运动功能无明显影响;②Hp感染对胃食管反流病患者的食管酸暴露也没有显著影响;③Hp感染与胃食管反流病的发生没有明显关系。
文摘目的评价综合抗反流术式在贲门外科临床应用的效果。方法将33例贲门癌患者食管胃吻合术中采用综合抗反流术者作为A组,另选取临床资料相仿,但未行综合抗反流术的8例贲门癌手术患者作为B组对照,通过手术前后食管胃腔内测压以及24 h pH值测定评价抗反流效果。结果A组术后食管体部出现新的高压区,其pH<4的总时间(%)、pH<4的反流次数、>5 min的反流次数各项指标均较B组明显减少(P<0.01)。结论综合抗反流术式方法简便,临床抗反流效果好,值得在贲门外科中推广应用。
文摘目的探讨胡桃夹食管(NE)的病理生理机制和临床特点。方法回顾性分析2015~2017年南方医科大学南方医院17例胡桃夹食管患者的临床资料。结果 17例胡桃夹食管患者中,胸痛14例(82.4%),后背痛1例(5.9%),咽部不适6例(35.3%),反酸4例(23.5%),嗳气5例(29.4%),吞咽困难3例(17.6%),烧心4例(23.5%)。内镜检查显示,慢性浅表性胃炎11例(64.7%),慢性胃炎伴食管糜烂1例(5.9%),十二指肠糜烂2例(11.8%),十二指肠球炎2例(11.8%),食管裂孔疝1例(5.9%)。食管测压发现,远端收缩积分(DCI)>8 000 mm Hg.s.cm 4例(23.5%),5 000~8 000 mm Hg.s.cm10例(58.8%);食管远段(LES上沿以上11.0 cm)波幅>180mm Hg 3例(17.6%),食管近段(LES上沿以上3.0 cm)波幅>180 mm Hg 9例(52.9%),食管中段(LES上沿以上7.0 cm)波幅>180 mm Hg 8例(47.1%);8例中段波幅增高患者中,1例近段波幅同时增高,2例远段波幅同时增高。24 h pH监测显示,De Meester评分阳性2例(11.8%);酸反流次数增多1例(5.9%),弱酸反流次数增多2例(11.8%),弱碱反流次数增多2例(11.8%),总反流次数增多2例(11.8%)。结论 NE临床表现多样,高分辨食管测压是诊断NE的有效方法,NE的病因不明,可能与胃食管反流及精神心理因素有关,或是某一食管运动异常的早期表现。
文摘目的分析难治性胃食管反流(GERD)相关疾病食管动力特点及功能,并探讨不同吞咽试验对食管动力障碍的检出情况。方法选取遵义医学院附属医院2016年2月—2018年2月收治的难治性GERD患者40例,根据疾病类型分为反流性食管炎(RE)11例、非糜烂性反流(NERD)组17例和症状-反流无关联组12例。患者均进行胃镜检查、24 h pH联合阻抗监测、高分辨率食管测压。比较3组患者胃食管反流症状及食管动力特点(酸暴露时间、酸反流次数、非酸反流次数);比较3组患者食管动力功能指标[食管插约面(LES)长度、腹腔内LES长度、常规吞咽蠕动率、LES静息压、连续性饮水吞咽次数、连续性饮水吞咽花费时间、食管有效收缩率、LES收缩率]、食管动力障碍检出情况。结果 3组患者反流性疾病问卷(RDQ)积分及非酸反流次数比较,差异无统计学意义(P>0.05);NERD组、症状-反流无关联组酸暴露时间短于RE组,酸反流次数少于RE组(P<0.05)。3组患者LES长度,腹腔内LES长度、常规吞咽蠕动率、LES静息压、连续饮水吞咽次数及连续饮水吞咽花费时间比较,差异无统计学意义(P>0.05);NERD组、症状-反流无关联组食管有效收缩率、LES收缩率高于RE组(P<0.05)。3组患者常规吞咽试验、固体吞咽试验食管动力障碍检出率比较,差异无统计学意义(P>0.05)。结论 GERD患者中RE、NERD和症状-反流无关联患者胃食管反流症状相似,非酸反流次数相当,但NERD和症状-反流无关联患者的酸暴露时间短、酸反流次数少,食管有效收缩率、LES收缩率高,食管动力功能较强,且不同吞咽试验对食管动力障碍检出情况相当。
