论文部分内容阅读
目的探讨非器质性吞咽困难及非心源性胸痛与食管测压异常之间的关系。方法用4腔灌注导管进行食管压力测定122例,共发现25例非特异性食管运动障碍(NEMD)患者。结果以吞咽困难为主要症状的15例患者中2例表现为下食管括约肌(LES)高压;5例表现为食管下段低幅收缩;1例呈长时限蠕动收缩;4例表现为食管下段高幅蠕动性收缩;1例表现为较多第三收缩;1例表现为LES松弛不全;1例表现为LES松弛时程短暂或不松弛。以胸痛为主要表现的7例患者中胡桃夹食管2例;食管下段高幅蠕动收缩3例;LES松弛不全1例;食管下段低幅蠕动1例。同时具有胸痛和吞咽困难的3例患者中2例表现为食管下段高幅非蠕动性收缩,1例表现为LES松弛不全伴食管下段高幅蠕动性收缩。结论食管蠕动呈低幅收缩,自主性同步收缩,第三收缩,失蠕动,长时限蠕动收缩,小于160mmHg的高幅蠕动性收缩,LES高压,松弛不全,松弛时程短暂或不松弛的患者,其症状往往以吞咽困难为主;而胡桃夹食管,波幅在200mmHg以上的食管高幅蠕动收缩的患者,其症状则以胸痛为主。以胸痛为主要表现的患者疗效较好,而以吞咽困难为主要表现的患者疗效欠佳。
Objective To investigate the relationship between non-organic dysphagia and non-cardiac chest pain and esophageal manometry abnormalities. Methods A total of 122 cases of esophageal pressure were measured by 4-lumen perfusion catheter. A total of 25 patients with nonspecific esophageal dyskinesia (NEMD) were found. Results Among the 15 patients with dysphagia as the main symptom, 2 cases showed lower esophageal sphincter (LES) hypertension, 5 cases showed low-grade esophageal contraction, 1 case showed long-term peristalsis, 4 cases showed high esophageal lower extremity 1 case showed more third contractions; 1 case showed LES laxity; 1 case showed LES relaxation time is short or not relaxation. In 7 patients with chest pain as the main symptom, 2 cases of Nutcracker esophagus were found; 3 cases of high peristalsis of lower esophagus and 1 case of LES laxity; 1 case of lower esophageal peristalsis. Two of the three patients with chest pain and dysphagia presented with high non-creep constriction in the lower esophagus and one with LES laxity with high creep contraction in the lower esophagus. Conclusion Esophageal peristalsis showed low amplitude systolic, voluntary systolic systolic, third systolic and diastolic, long-term peristaltic contractions, high amplitude writhing less than 160mmHg, high LES pressure, incomplete relaxation, short or loose relaxation time, The symptoms are often dysphagia; and nutcracker esophagus, amplitude of more than 200mmHg esophageal high peristalsis contractions patients, the symptoms are mainly chest pain. Patients with chest pain as the main manifestation of better efficacy, while dysphagia as the main performance of patients with poor efficacy.