中华胃食管反流病电子杂志 ›› 2022, Vol. 09 ›› Issue (03) : 147 -150. doi: 10.3877/cma.j.issn.2095-8765.2022.03.002 × 扫一扫
论著
收稿日期:
出版日期:
通信作者:
Min Wen1, Hongqin Liu1,†(), Wenjuan Weng1, Xingliang Yin1, Liya Luo1, Jinjie Huang1, Qing Xu1
Received:
Published:
Corresponding author:
文敏, 刘洪琴, 王文娟, 尹兴亮, 罗丽娅, 黄婧洁, 徐青. 探索提高高分辨率食管测压中滑动性食管裂孔疝阳性检出率方法的运用研究[J]. 中华胃食管反流病电子杂志, 2022, 09(03): 147-150.
Min Wen, Hongqin Liu, Wenjuan Weng, Xingliang Yin, Liya Luo, Jinjie Huang, Qing Xu. Explore the application of improving the positive detection rate of sliding esophageal hiatal hernia in high-resolution esophageal pressure measurement[J]. Chinese Journal of Gastroesophageal Reflux Disease(Electronic Edition), 2022, 09(03): 147-150.
探讨高分辨率食管测压（HREM）中采用腹部施压技术在提高滑动性食管裂孔疝阳性检出率方面的应用价值。
收集行HREM的病例200例，分为对照组和观察组各100例（入组病例均为胃镜检查有食管裂孔疝或贲门松弛，或拟诊胃食管反流病但胃镜检查阴性，在排除禁忌症及停用促动力药物1周，最后行胃镜下或腹腔镜抗反流手术治疗的病例）；观察组在HREM常规操作中对未发现疝征像的病例再进一步行腹部施压法，模拟腹压增高对食管和胃结合部部位形态的观察；对照组则采用常规操作技术。最后依据胃镜及腹腔镜术中诊断，比较两种方法在滑动性食管裂孔疝阳性检出率方面的差异性及检出效能。
200例病例中，观察组进一步采用腹部施压法对滑动性食管裂孔疝阳性检出例数（率）为81例（ 81% ），对照组进行常规操作对滑动性食管裂孔疝阳性检出例数（率）为56例（56% ），二者差异具有显著性（P＜0.05）。
HREM中进一步采用腹部施压技术模拟腹压增高可显著提高滑动性食管裂孔疝检出率。
To explore the application value of abdominal pressure technique in high-resolution esophageal manometry in improving the positive detection rate of sliding hiatal hernia.
200 cases with high-resolution esophageal manometry were collected and divided into control group and observation group with 100 cases in each group (all the cases in the group were cases with esophageal hiatal hernia or cardia relaxation by gastroscopy, or those who were suspected of gastroesophageal reflux disease but were negative by gastroscopy, and were finally treated by gastroscopy or laparoscopic anti-reflux surgery after exclusion of contraindications and discontinuation of propulsive drugs for one week). In the observation group, in the routine operation of high-resolution esophageal manometry, the cases without hernia signs were further subjected to abdominal pressure method to simulate the observation of the morphology of the junction of esophagus and stomach by increasing abdominal pressure. The control group was treated with routine operation techniques. Finally, according to the diagnosis of gastroscopy and laparoscopy, the difference and detection efficiency of the two methods in the positive detection rate of sliding hiatal hernia were compared.
Among the 200 cases, 81 cases (81%) were detected in the observation group by abdominal pressure, and 56 cases (56%) were detected in the control group by routine operation, with significant difference (P＜0.05).
Using abdominal pressure technique to simulate the increase of abdominal pressure in high-resolution esophageal manometry can significantly improve the detection rate of sliding hiatal hernia.