胃食管反流病的诊断性检查：何人、何时转诊以及进行何种检查？
Diagnostic Investigations of Gastroesophageal Reflux Disease: Who and When to Refer and for What Test?
作者信息
Kandulski Arne, Moleda Lukas, Müller-Schilling Martina
机构信息
Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany.
出版信息
Visc Med. 2018 Apr;34(2):97-100. doi: 10.1159/000488184. Epub 2018 Apr 20.
BACKGROUND
Due to the high prevalence and incidence of patients with gastroesophageal reflux disease (GERD), the diagnostic workup of patients with symptoms of GERD needs to be balanced between empiric antisecretory therapy and further functional assessment including endoscopy and reflux monitoring.
METHODS
This article is based on a literature review (PubMed, Medline) using the terms 'gastroesophageal reflux disease' or 'GERD' and 'diagnosis', 'therapy', or 'PPI' with special and critical analysis of the current 'Porto' consensus report.
RESULTS AND CONCLUSIONS
Further diagnostics are mandatory in case of alarm symptoms as well as atypical or persistent symptoms under adequate therapy with proton pump inhibitors (PPI). In general, the clinical situation needs to be clarified before sending the patients for reflux monitoring. The question is not only when and whom to test but also how to test: or PPI therapy, pH-metry, or combined pH-impedance analysis. These questions have been defined in a recent consensus report of an international panel of experts and are further discussed in this article.
背景
由于胃食管反流病（GERD）患者的高患病率和发病率，GERD症状患者的诊断检查需要在经验性抗分泌治疗与包括内镜检查和反流监测在内的进一步功能评估之间取得平衡。
方法
本文基于文献综述（PubMed、Medline），使用术语“胃食管反流病”或“GERD”以及“诊断”“治疗”或“PPI”，并对当前的“波尔图”共识报告进行了特别和批判性分析。
结果与结论
出现警示症状以及在使用质子泵抑制剂（PPI）进行充分治疗后仍有非典型或持续性症状时，必须进行进一步诊断。一般来说，在将患者送去进行反流监测之前，需要明确临床情况。问题不仅在于何时以及对谁进行检测，还在于如何检测：是进行PPI治疗、pH值测定，还是联合pH值-阻抗分析。这些问题已在国际专家小组最近的一份共识报告中得到界定，本文将进一步讨论。
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