食管pH胶囊对GERD的诊断价值

发布时间：2018-05-14 08:52

  本文选题：食管pH胶囊(OMOM) + 胃食管反流病　； 参考：《福建医科大学》2014年硕士论文

【摘要】：第一部分 食管pH胶囊对胃食管反流病的诊断价值研究 目的：探讨国产食管pH胶囊在胃食管反流病中的的诊断价值。 方法：选取临床诊断为胃食管反流病（GERD）的28例患者进行导管式24h食管pH监测检查，间隔1天后进行食管pH胶囊监测检查，pH胶囊及pH导管探头均放置于胃食管交界处以上6cm处，比较患者对两种方法的耐受情况，并分析比较两者数据之间的差异性。 结果：28例GERD患者均完成了两种检测方法，4例患者因食管pH胶囊本身技术故障，另2例患者因pH胶囊过早脱落，导致检测时间未达到48h，，以上6例的食管pH监测数据均被排除。剩余22例患者顺利的完成了48h的食管pH胶囊监测。患者对食管pH胶囊的耐受性良好。并对比分析两种检测方法的数据，得出食管pH胶囊对GERD的诊断敏感性为93.33%，特异性为85.71%，准确性为90.91%。与导管式食管pH监测比较，食管pH胶囊组的总的pH＜4的百分时间（8.5%），直立位pH＜4的时间（10.4%），总的反流次数（42.6次）均显著高于导管组（分别为6.4%，6.2%，26.4次），各指标比较有统计学差异（P均0.05）。且食管pH胶囊组和导管式pH监测组关于食管酸反流方面的相关性比较，亦有显著的相关性（r=0.87，P0.0001）。食管pH胶囊组第二天的pH值4占总时间的百分比（8.5），pH值4的直立位时间百分比（12.5），平均长反流的次数（26.4）均显著高于第一天的，各指标比较有统计学意义（P0.05） 结论：与导管式24h食管pH监测方法比较，国产食管pH胶囊检测方法的有效性高、耐受性好，食管pH胶囊是适合用于诊断胃食管反流病的食管内酸反流的理想检查工具。 第二部分 同步进行导管式24小时食管pH监测与食管pH胶囊监测的一致性的临床研究 目的： 探讨同步进行导管式24小时食管pH监测系统与食管pH胶囊监测系统检测GERD患者食管酸反流的相关性及一致性。 方法： 24例拟诊为GERD的患者，同时将导管式24h食管pH监测的导管前端的电极与国产食管pH胶囊的电极置于食管下括约肌上方5cm处，分别应用对应的接收器接收数据，分别记录24小时及48小时的食管pH数据，并进行比较，研究其相关性和一致性，期间记录患者不适症状。 结果： 在第一天，食管pH胶囊组检测到pH4占总时间的%数值比导管式24h食管pH监测组更低（5.8%VS.6.8%，p＜0.05）；两组检测的结果存在显著的相关性（r=0.90，P0.0001）。两种检测方法诊断GERD的一致性为86.4%。食管pH胶囊组中，检测48h与第一天相比，对食管酸反流各指标间的结果均有显著性差异（P0.05）；而48h与第二天比较，在总的、直立位时pH4所占的时间百分比有显著性差异（P0.05）。同样，对比了患者对这2种方法的主观感觉，大部分患者诉在第一天能感觉到更多的恶心和咽喉部不适等症状。 结论： 两种检测系统对食管酸反流的监测方面有很强的相关性及一致性；因此国产食管pH胶囊可以应用于临床上GERD的诊断，而且延长食管pH胶囊的监测时间能够进一步减少测量的变异性和提高诊断敏感性。
[Abstract]:Part one
Diagnostic value of pH capsule for gastroesophageal reflux disease
Objective: To investigate the diagnostic value of domestic pH capsule in gastroesophageal reflux disease.
Methods: 28 patients who were diagnosed as gastroesophageal reflux disease (GERD) were examined by catheter type 24h esophagus pH monitoring, and the esophageal pH capsule was monitored for 1 days. The pH capsule and pH catheter probe were placed in the 6cm above the gastroesophageal junction, and the patient's tolerance to the two methods was compared and the data were analyzed and compared. Differences.
Results: two kinds of detection methods were completed in 28 cases of GERD, 4 patients were due to the technical failure of esophageal pH capsule itself, and the other 2 patients were premature falling off of pH capsule, resulting in the detection time not reaching 48h. The above 6 cases of esophageal pH monitoring data were eliminated. The remaining 22 patients successfully completed the 48h esophageal pH capsule monitoring. Patients with esophageal pH glue The tolerance of the capsule was good. And compared and analyzed the data of the two detection methods, the sensitivity of the esophageal pH capsule to GERD was 93.33%, the specificity was 85.71%, the accuracy was 90.91%. and the catheter type esophageal pH monitoring, the total pH < 4 percent time (8.5%) of the esophagus pH capsule group, the erect position pH < 4 (10.4%), the total reflux times (42.) The 6 times were significantly higher than that of the catheter group (6.4%, 6.2%, 26.4 times respectively), and the indexes were statistically different (P 0.05). The correlation between the esophageal pH capsule group and the catheter type pH monitoring group on esophageal acid reflux correlation was also significant (r=0.87, P0.0001). The pH value of the esophageal pH capsule group was 4 of the total time (8.5), pH The median time percentage (12.5) and the average number of long reflux (26.4) were significantly higher than those of the first day (4), and the indexes were statistically significant (P0.05).
Conclusion: compared with the catheter based 24h esophagus pH monitoring method, the domestic pH capsule detection method is effective and well tolerated, and the esophageal pH capsule is an ideal examination tool for the diagnosis of gastroesophageal reflux disease.
The second part
Clinical study on synchronizing catheter 24 hour esophageal pH monitoring with pH monitoring of esophageal cancer
Objective:
Objective to explore the correlation and consistency of 24 hour esophageal pH monitoring system and esophageal pH capsule monitoring system in detecting esophageal acid reflux in GERD patients.
Method锛

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