Ivashkin V T, Maev I V, Trukhmanov A S, Storonova O A, Kucheryavyi Yu A, Barkalova E V, Ovsepyan M A, Andreev D N, Paraskevova A B, Rumyantseva D E
Federal State Autonomous Educational Institution of Higher Education I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia.
Federal State Budgetary Educational Institution of the Higher Education "A.I. Yevdokimov Moscow State University of Medicine and Dentistry" of the Ministry of Healthcare of the Russian Federation, Moscow, Russia.
Ter Arkh. 2018 May 11;90(5):93-100. doi: 10.26442/terarkh201890593-100.
To present application of Chicago classification criteria of esophageal motility disorders defined in high resolution manometry in clinical practice.
High-resolution manometry is the most exact hi-tech diagnostic method for esophageal motor function disorders according to Chicago classification v3.0. Uniqueness of the method consists in capacity to define integrated quantitative and qualitative metrics of esophageal contractile function and to establish their specific disorders e.g.: change of intrabolus pressure at disorders of esophagogastric junction (EGj) outflow, hypercontractile esophagus, fragmented contractions and weak or failed peristalsis, distal esophageal spasm. Assessment of the type of achalasia subtypes has significant impact on the patients' treatment choice. According to anatomical location of the lower esophageal sphincter and crural diaphragm several morphological types of gastro-esophageal junction are defined that determine severity of gastroesophageal reflux disease. Multiple rapid swallow responses during esophageal high-resolution manometry reflect esophageal body peristaltic reserve and is a predictor of postoperative complications. Differential diagnosis of belching type became possible at combined application of high-resolution manometry and impedance measurement.
High-resolution manometry is a fundamental diagnostic test of esophageal motor function disorders. Clinical application of this method significantly expands diagnostic potential and allows to carry out personalized treatment that increases treatment quality.
介绍高分辨率测压法定义的食管动力障碍的芝加哥分类标准在临床实践中的应用。
根据芝加哥分类v3.0，高分辨率测压法是诊断食管运动功能障碍最精确的高科技方法。该方法的独特之处在于能够定义食管收缩功能的综合定量和定性指标，并确定其特定障碍，例如：食管胃交界处（EGj）流出障碍时团内压的变化、食管高收缩、收缩破碎以及蠕动减弱或消失、食管远端痉挛。贲门失弛缓症亚型的评估对患者的治疗选择有重大影响。根据食管下括约肌和膈脚的解剖位置，定义了几种胃食管交界处的形态学类型，这些类型决定了胃食管反流病的严重程度。食管高分辨率测压期间的多次快速吞咽反应反映了食管体部的蠕动储备，是术后并发症的预测指标。高分辨率测压法与阻抗测量联合应用时，嗳气类型的鉴别诊断成为可能。
高分辨率测压法是食管运动功能障碍的基本诊断测试。该方法的临床应用显著扩展了诊断潜力，并允许进行个性化治疗，从而提高治疗质量。
