弥漫性食管痉挛84例临床分析

发布时间：2018-02-23 22:05

本文关键词： 弥漫性食管痉挛食管测压临床表现诊断　出处：《广东医学》2016年12期 　论文类型：期刊论文

【摘要】：目的探讨弥漫性食管痉挛(DES)的临床表现及食管测压特点。方法回顾性分析对比84例DES患者(DES组)及60例反流性食管炎患者(RE组)的临床资料,分析其临床表现、胃镜、钡餐及食管测压结果。结果 (1)临床表现:DES组以胸痛和吞咽困难为主,RE组以胸痛、反酸、烧心为主,两组相比差异有统计学意义(P0.05)。(2)胃镜检查:胃镜检查诊断DES、RE的阳性率分别为29.7%、50.0%,两者差异有统计学意义(P0.05)。(3)钡餐检查:食管钡餐在诊断DES、RE的阳性率分别为28.5%、71.6%,两者差异有统计学意义(P0.05)。(4)食管测压:DES组在食管测压检测中食管体部出现同步收缩波、多发重复收缩波占73.8%,湿咽成功率为62.36%。RE组食管体部近端和远端压力、下食管括约肌压力、食管括约长度均低于正常值,多发重复收缩波占20.0%,湿咽成功率84.2%,两者差异有统计学意义(P0.01)。结论 DES临床表现以胸痛和吞咽困难为主,且与病变部位相一致,以食管中上段为主;而反流性食管炎病变以食管中下段为主。食管测压是诊断DES较为准确的方法,较胃镜和钡餐更准确,有助于提高DES诊断,做到早期诊断,以减少误诊。
[Abstract]:Objective to investigate the clinical manifestations and esophageal manometry of diffuse esophageal spasm (des). Methods the clinical data of 84 DES patients with des) and 60 patients with reflux esophagitis (RE) were analyzed retrospectively. Barium meal and esophageal manometry. Results 1) the clinical manifestations of the group were chest pain and dysphagia. The RE group was characterized by chest pain, acid regurgitation and heartburn. Gastroscopy: the positive rate of gastroscopy in the diagnosis of DESRE was 29.70.00.The difference between the two groups was statistically significant (P0.05. 3) barium meal examination: the positive rate of esophageal barium meal in the diagnosis of DESREE was 28.5571.6, respectively, and there was a difference between the two groups. There were synchronous contractions in the esophageal body in the esophageal manometry group (P < 0.05) and the esophageal body contraction wave in the esophageal manometry group (n = 10), while in the esophageal manometry group, a synchronous contraction wave appeared in the esophageal body. The success rate of wet pharynx was 62.36.RE group had lower esophageal sphincter pressure, lower esophageal sphincter pressure, lower esophageal sphincter pressure and lower esophageal sphincter length than normal. Multiple repeated contractions accounted for 20.0%, and the success rate of wet pharynx was 84.2%. The difference was statistically significant (P 0.01). Conclusion the clinical manifestations of DES are mainly chest pain and dysphagia, which are consistent with the location of the lesion and mainly in the middle and upper esophagus. Esophageal manometry is a more accurate method for diagnosing DES, which is more accurate than gastroscopy and barium meal. It is helpful to improve the diagnosis of DES and to make early diagnosis so as to reduce misdiagnosis.
【作者单位】：中国人民解放军第169医院暨湖南师范大学附属湘南医院消化内科;
【分类号】：R571

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