Stuart R C, Byrne P J, Lawlor P, O'Sullivan G, Hennessy T P
Department of Surgery, St James's Hospital, Dublin, Ireland.
Br J Surg. 1992 Nov;79(11):1162-6. doi: 10.1002/bjs.1800791118.
Ambulatory non-perfused oesophageal manometry was used to study oesophageal body function during consumption of a full meal in patients with achalasia. A measure of oesophageal body activity (the meal area index) was developed by calculating the total area under the pressure curve during eating, above the preprandial baseline oesophageal pressure, per meal minute. Untreated patients with achalasia (n = 13) were compared with normal subjects (n = 42), patients with benign stricture (n = 9) and patients with achalasia who had undergone Heller's myotomy (n = 17). The results showed a high meal area index in achalasia, due to a rise in baseline oesophageal pressure and frequent high-amplitude contractions during eating. This was not seen in normal subjects or patients with stricture. The high meal area index was abolished by successful Heller's myotomy but remained in two patients with persisting dysphagia. Sustained high intraoesophageal pressure is generated during consumption of a solid meal in untreated achalasia, resulting in a unique manometric profile. Manometry during eating using the meal area index permits quantitative assessment of oesophageal body function in achalasia and may aid in the assessment of response to treatment.
采用动态非灌注食管测压法研究贲门失弛缓症患者进食一顿正餐时食管体部功能。通过计算进食期间压力曲线下、高于餐前食管基线压力的每进餐分钟总面积，得出一项食管体部活动指标（进餐面积指数）。将未经治疗的贲门失弛缓症患者（n = 13）与正常受试者（n = 42）、良性狭窄患者（n = 9）以及接受过赫勒肌切开术的贲门失弛缓症患者（n = 17）进行比较。结果显示，贲门失弛缓症患者的进餐面积指数较高，这是由于食管基线压力升高以及进食期间频繁出现高幅度收缩所致。正常受试者或狭窄患者未见此情况。成功的赫勒肌切开术可消除较高的进餐面积指数，但两名持续性吞咽困难患者的该指数仍较高。未经治疗的贲门失弛缓症患者在进食固体餐时会产生持续的高食管内压力，从而导致独特的测压特征。使用进餐面积指数进行进食期间测压可对贲门失弛缓症患者的食管体部功能进行定量评估，并可能有助于评估治疗反应。
