食管裂孔__

食管裂孔疝伴胃食管反流病的胃食管动力学研究

http://www.100md.com 《包头医学院学报》 2006年第1期

食管裂孔,,疝；食管裂孔；胃食管反流；内镜；pH监测；测压法；胃磁图,1对象与方法,2结果,3讨论,参考文献

     摘要目的：探讨食管裂孔疝(HH)伴胃食管反流病(GERD)患者与单纯HH及GERD患者之间的内镜、24h食管pH监测、食管测压、胃动力学检查之间的相关性。方法：经胃镜确诊的HH伴GERD患者61例，同期内镜确诊单纯HH患者28例，GERD患者30例，在一周内进行24h食管pH监测、食管下端括约肌(LES)压力测定及胃磁图测定胃半排空时间。结果：GERD中pH监测诊断同内镜诊断相符合占83.52%，不符合占1648%。24h pH监测中，HH伴GERD组患者的总反流时间、卧位反流时间及立位反流时间百分比均显著高于GERD组和HH组，GERD组显著高于HH组；HH伴GERD组LESP显著低于HH组和GERD组，HH组LESP显著低于GERD组；HH伴GERD组LESL显著短于GERD组，HH伴GERD组和HH组LESL无显著差异，HH组LESL显著短于GERD组；HH伴GERD组LESR显著高于HH组和GERD组，HH组LESR显著高于GERD组；HH伴GERD组胃排空延缓者显著多于HH组，但与GERD组无显著差异，GERD组胃排空延缓者显著多于HH组。

    关键词疝；食管裂孔；胃食管反流；内镜；pH监测；测压法；胃磁图

    Gastroesophageal Motility in Patients with Sliding Hiatus Hernia and Gastroesophageal Reflux Disease

    ZHAO Guijun,HUO Jiangbo,LI Peng，LIANG Guoshi

    (Research Center of Gastroenterology Inner Mongolia,Baotou 014030,China)

    Abstract Objective: To study changes in gastroesophageal motility of patients with sliding hiatus hernia (HH) and gastroesophageal reflux disease.Methods: 61 HH&GERD patients, 28 HH patients and 30 GERD patients were diagnosed with gastroscopy to monitor 24-hour esophageal pH and to determine gastric half-emptying time with gastromagneticgram, and the lower esophageal sphincter (LES) pressure. Results: Among GERD, the percentage of pH monitoring diagnosis conforming to gastroesophageal diagnosis is 83.52%.1648% does not conform to gastroeo-phageal diagnosis During 24-hour esophageal pH monitoring, the percentages of total, supine and upright acid exposure time of HH& GERD group are greater than those in GERD group and HH group. (Percentages of upright acid exposure time of HH& GERD group and upright acid exposure time of GERD group are P<0.05. Others are P<0.01) GERD group is higher than HH group remarkably (P<0.05). LESP in HH&GERD group is lower than that in HH group and GERD group (P<0.01). LESP in HH group is lower than that in GERD group (P<0.01). LESL in HH&GERD group is shorter than that in GERD group (P<0.01). LESL in HH&GERD group shows no significant differences from LESL in HH group. LESL in HH group is shorter than that in GERD group (P<0.01). LESR in HH&GERD group is higher than that LESR in HH group and in GERD group (P<0.01). LESR in HH group is higher than that in GERD group (P<0.01). Patients of gastric emptying delay in HH&GERD group are much more than those in HH group (P<0.01). Patients of gastric emptying delay in HH&GERD group show no significant differences from those in GERD group. Patients of gastric emptying delay in GERD group aremuch more than patients in HH group (P<0.01). ......

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