Höhne Sven, Arndt Martin, Hesse Viola
Martin-Luther-University Halle-Wittenberg, University Hospital, Clinic of Pediatric Surgery, 06120, Halle, Ernst-Grube Street 40, Germany.
Martin-Luther-University Halle-Wittenberg, Department of Operative and Conservative Medicine in Children and Adolescents, Clinic of Pediatric Surgery, Laboratory of Function Diagnostic, Halle, Germany.
Open Med (Wars). 2018 Jun 14;13:232-236. doi: 10.1515/med-2018-0036. eCollection 2018.
The well-established methods for esophageal manometry have some disadvantages: the-water-perfused catheters needs calibration by gravity and measuring in supine position, and the solid-state catheters are very expensive. Manometry using gas-perfused catheters is a suitable alternative. There have been only a few publications about this.
The results for esophageal manometry in 1700 patients were retrospectively analyzed based on the clinical reports and the manometry data. The gas-perfusion manometry was critically assessed.
The mean age was 54 years. The indications for esophageal manometry were GER symptoms in 58.5% (pathological DeMeester score in 41.8%), dysphagia in 12.4%, and already known achalasia in 8.9%. Motility disorders could be found in 40% of the patients with GER symptoms (51% of the patients with pathological DeMeester score), and in 88% of achalasia patients. The resting LES pressure was 8.9±5.94 mmHg with GER symptoms, 16.4±12.79 mmHg without GER symptoms, and 26.8±14.03 mmHg with achalasia. The relaxation LES pressure was 20.0±10.93 mmHg in achalasia patients, and 8.3±5.77 mmHg in the others.The gas-perfusion manometry was well tolerated by all patients without any serious complications.
Manometry using gas-perfused catheters is an easy to handle and inexpensive method to investigate the esophageal motility. The suitability of gas perfusion with helium for esophageal manometry depends on physical and technical requirements, such as a constant gas flow, a dead space in the transducer, and the catheter being as small as possible. In consideration of this, the detection of the pressure changing in swallowing acts is excellent. The measured LES pressures are generally lower than with other methods like with water-perfused or solid-state catheters, possibly because of the higher compliance in a gas-filled surrounding. The normal values in gas-perfusion manometry are comparable but not identical with the values of other manometric methods.
成熟的食管测压方法存在一些缺点：水灌注导管需要通过重力校准并在仰卧位测量，而固态导管非常昂贵。使用气体灌注导管进行测压是一种合适的替代方法。关于这方面的出版物很少。
基于临床报告和测压数据，对1700例患者的食管测压结果进行回顾性分析。对气体灌注测压进行了严格评估。
平均年龄为54岁。食管测压的适应证为胃食管反流症状（GER）占58.5%（41.8%患者DeMeester评分异常），吞咽困难占12.4%，已知贲门失弛缓症占8.9%。在GER症状患者中，40%可发现动力障碍（DeMeester评分异常患者中为51%），贲门失弛缓症患者中88%可发现动力障碍。有GER症状患者的静息LES压力为8.9±5.94 mmHg，无GER症状患者为16.4±12.79 mmHg，贲门失弛缓症患者为26.8±14.03 mmHg。贲门失弛缓症患者的LES松弛压力为20.0±10.93 mmHg，其他患者为8.3±5.77 mmHg。所有患者对气体灌注测压耐受性良好，无任何严重并发症。
使用气体灌注导管进行测压是一种易于操作且廉价的研究食管动力的方法。氦气气体灌注用于食管测压的适用性取决于物理和技术要求，如恒定的气体流量、传感器中的死腔以及导管尽可能小。考虑到这一点，吞咽动作时压力变化的检测效果极佳。测得的LES压力通常低于水灌注或固态导管等其他方法，可能是因为气体填充环境中的顺应性更高。气体灌注测压的正常值与其他测压方法的值可比但不相同。
