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成人矫正型食管闭锁:食管功能与主诉及生活质量相关吗?

Adults with corrected oesophageal atresia: is oesophageal function associated with complaints and/or quality of life?

作者信息

Deurloo J A, Klinkenberg E C, Ekkelkamp S, Heij H A, Aronson D C

机构信息

Pediatric Surgical Center of Amsterdam, Emma Children's Hospital AMC, 1100 DD, Amsterdam, The Netherlands.

出版信息

Pediatr Surg Int. 2008 May;24(5):537-41. doi: 10.1007/s00383-008-2120-1. Epub 2008 Mar 20.

Abstract

The aim of this study was to evaluate oesophageal function after correction of oesophageal atresia in adults, and to investigate the association between complaints, oesophageal function and quality of life (QoL). Twenty-five adults were included who participated in previous follow-up studies, during which complaints of dysphagia and gastro-oesophageal reflux (GOR), results of upper gastrointestinal endoscopy, oesophageal biopsies and QoL had been collected. Manometry was performed in 20 patients, 24 h pH-measurements were performed in 21 patients. pH-values (sample time 5 s) were calculated using criteria of Johnson and DeMeester. Associations were tested with ANOVA and chi (2)-tests. Ten patients (48%) reported complaints of dysphagia, seven (33%) of GOR. The amplitude of oesophageal contractions was low (<15 mmHg) in four patients (20%). pH-measurements showed pathological reflux in three patients (14%). Patients reporting dysphagia more often had disturbed motility (P = 0.011), and lower scores on the domains "general health perceptions" (SF-36) (P = 0.026), "standardised physical component" (SF-36) (P = 0.013), and "physical well-being" (GIQLI) (0.047). No other associations were found. This study shows a high percentage of oesophageal motility disturbances and a moderate percentage of GOR after correction of oesophageal atresia. Patients reporting dysphagia, whom more often had disturbed motility, seemed to be affected by these symptoms in their QoL.

摘要

本研究旨在评估成人食管闭锁矫正术后的食管功能,并调查症状、食管功能与生活质量(QoL)之间的关联。纳入了25名参与过既往随访研究的成年人,在此期间收集了吞咽困难和胃食管反流(GOR)症状、上消化道内镜检查结果、食管活检及生活质量情况。对20名患者进行了测压,对21名患者进行了24小时pH值测量。pH值(采样时间5秒)根据约翰逊和德梅斯特的标准计算。采用方差分析和卡方检验来检验关联性。10名患者(48%)报告有吞咽困难症状,7名(33%)有胃食管反流症状。4名患者(20%)食管收缩幅度较低(<15 mmHg)。pH值测量显示3名患者(14%)存在病理性反流。报告有吞咽困难的患者更常出现运动功能障碍(P = 0.011),在“总体健康感知”(SF - 36)领域得分较低(P = 0.026),“标准化身体成分”(SF - 36)领域得分较低(P = 0.013),以及“身体幸福感”(GIQLI)得分较低(0.047)。未发现其他关联性。本研究表明,食管闭锁矫正术后食管运动功能障碍的比例较高,胃食管反流的比例适中。报告有吞咽困难的患者更常出现运动功能障碍,他们的生活质量似乎受到这些症状的影响。

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