Ahlawat Sushil K, Novak David J, Williams Dionne C, Maher Kathleen A, Barton Franca, Benjamin Stanley B
Division of Gastroenterology, Department of Medicine, Georgetown University Hospital, Washington, DC, USA.
J Clin Gastroenterol. 2006 Jan;40(1):20-4. doi: 10.1097/01.mcg.0000190753.25750.0e.
BACKGROUND & GOALS: The wireless pH monitoring system such as the BRAVO pH system is a significant advancement in the evaluation of patients with gastroesophageal reflux because of its potentially better tolerability and the ability to record data over a 48-hour period. The aim of our study was to evaluate safety, performance, tolerability, and day-to-day variability in acid reflux patterns using the BRAVO pH system.
A total of 90 consecutive patients (48 men and 42 women) with persistent reflux symptoms underwent BRAVO pH capsule placement from October 2002 to August 2003 at a tertiary care hospital. The BRAVO pH capsule was deployed 6 cm proximal to the squamocolumnar junction under endoscopic guidance. The pH recordings over 48 hours were obtained after uploading data to a computer from the pager-like device that recorded pH signals from the BRAVO pH capsule.
Successful pH data over 48 hours was obtained in 90% of patients. Nearly two thirds of patients experienced a variety of symptoms ranging from a foreign body sensation to chest discomfort or pain. Four patients had severe chest pain, 3 of whom required endoscopic removal of the BRAVO pH capsule. In 74.4% of patients, number of reflux events as well as time (%) pH<4 correlated from the first 24-hour period to the second 24-hour period. However, in 28% of patients, no predictable pattern of (%) time pH<4 in the supine position was reproduced from one 24-hour period to the next 24-hour period.
The BRAVO pH system appears a safe and effective method of recording esophageal acid exposure. It is an acceptable alternative for patients who are unwilling or unable to tolerate nasopharyngeal catheter-based pH studies, and it has a potential advantage of the 2-day recording period.
无线pH监测系统，如BRAVO pH系统，在胃食管反流患者评估中是一项重大进展，因为它可能具有更好的耐受性，并且能够在48小时内记录数据。我们研究的目的是使用BRAVO pH系统评估酸反流模式的安全性、性能、耐受性和日常变异性。
2002年10月至2003年8月，一家三级护理医院对90例连续的有持续反流症状的患者（48例男性和42例女性）进行了BRAVO pH胶囊放置。BRAVO pH胶囊在内镜引导下放置于鳞柱状上皮交界处近端6 cm处。从类似寻呼机的设备将pH信号记录上传至计算机后，获取48小时内的pH记录，该设备记录BRAVO pH胶囊的pH信号。
90%的患者成功获得了48小时的pH数据。近三分之二的患者经历了从异物感到胸部不适或疼痛等各种症状。4例患者出现严重胸痛，其中3例需要通过内镜取出BRAVO pH胶囊。在74.4%的患者中，第一个24小时期间与第二个24小时期间的反流事件数量以及pH<4的时间百分比相关。然而，在28%的患者中，仰卧位时pH<4的时间百分比在前一个24小时期间与下一个24小时期间没有可预测的模式。
BRAVO pH系统似乎是一种安全有效的记录食管酸暴露的方法。对于不愿意或无法耐受基于鼻咽导管的pH研究的患者，它是一种可接受的替代方法，并且具有2天记录期的潜在优势。
