Department of Medicine, Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, PA, USA.
Division of Gastroenterology, Durham Veterans Affairs Medical Center, Duke University School of Medicine, Durham, USA.
Dig Dis Sci. 2018 Dec;63(12):3178-3186. doi: 10.1007/s10620-018-5300-4.
Esophageal high-resolution manometry (HRM) has advanced the understanding of esophageal motor function and the ability to diagnose and manage disorders of esophageal motility. In this review, we describe the indications for and the technical performance of HRM. The Chicago classification of esophageal motor function, now in its third iteration, streamlines and standardizes the nomenclature and basic interpretation of HRM data depicted as Clouse topographic plots. In clinical practice, HRM is an important diagnostic test for patients with dysphagia as well as patients with suspected gastroesophageal reflux disease (GERD), particularly in those patients with a suboptimal symptomatic response to antisecretory therapy. HRM can support diagnoses such as achalasia, as well as provide evidence for behavioral disorders such as rumination syndrome or supragastric belching with the assistance of postprandial HRM with impedance. Further, the GERD classification of motor function introduces a three-part hierarchical evaluation of esophageal motor function in GERD, highlighting the value of assessment of esophageal contractile reserve through provocative maneuvers during HRM such as multiple rapid swallows.
食管高分辨率测压（HRM）提高了对食管运动功能的理解，以及诊断和治疗食管动力障碍的能力。在这篇综述中，我们描述了 HRM 的适应证和技术性能。食管运动功能的芝加哥分类，现已进入第三版，简化和规范了 HRM 数据的命名和基本解释，这些数据以 Clouse 拓扑图表示。在临床实践中，HRM 是吞咽困难患者以及疑似胃食管反流病（GERD）患者的重要诊断测试，特别是在那些对抑酸治疗反应不佳的患者中。HRM 可以支持诸如贲门失弛缓症等诊断，并通过餐后 HRM 联合阻抗提供行为障碍的证据，例如反刍综合征或胃上嗳气。此外，GERD 运动功能分类对 GERD 中的食管运动功能进行了三部分分层评估，突出了通过 HRM 期间的激发性操作（如多次快速吞咽）评估食管收缩储备的价值。
