Division of Gastroenterology and Hepatology, The Esophageal and Swallowing Center, MetroHealth Medical Center, Case Western Reserve University, Cleveland, OH, USA.
Adv Ther. 2020 May;37(5):2560-2571. doi: 10.1007/s12325-020-01326-w. Epub 2020 Apr 13.
BACKGROUND/AIM: Diagnosis of esophageal motor disorders using high-resolution esophageal manometry (HREM) may result in medical, endoscopic or surgical intervention. However, prior to any intervention, durability of the HREM findings should be established. The aim of this case series was to assess 25 patients who had undergone HREM twice, at least 6 months apart, and to determine the durability of the initial manometric diagnosis.
This is a case series of 25 patients who underwent HREM at least twice, 6 months apart, at a large safety net hospital. All patients were evaluated in between the tests for any clinical intervention. Demographics, patients' indication for HREM and clinical presentation were documented as well.
Of the 25 patients, HREM results improved in 32%, worsened in 20% and were unchanged in 48%. Some interventions were employed between the first and second HREM diagnosis. Those associated with an improved diagnosis included doubling the proton pump inhibitor (PPI) dose, re-starting a PPI, adding a histamine 2 blocker (H2 blocker) and use of empiric dilation.
In this case series, about half of the patients undergoing two esophageal manometries, at least 6 months apart, demonstrated lack of durability of their initially diagnosed esophageal motor disorder.
背景/目的：使用高分辨率食管测压（HREM）诊断食管运动障碍可能会导致医疗、内镜或手术干预。然而，在进行任何干预之前，应该确定 HREM 检查结果的持久性。本病例系列研究的目的是评估 25 例至少两次接受 HREM 检查的患者，两次检查间隔至少 6 个月，以确定初始测压诊断的持久性。
这是一项在一家大型安全网医院进行的至少两次 HREM 检查的病例系列研究，两次检查间隔至少 6 个月。所有患者均在两次检查之间进行了任何临床干预评估。记录了人口统计学资料、患者 HREM 检查的指征和临床表现。
25 例患者中，32%的患者 HREM 结果改善，20%的患者恶化，48%的患者结果不变。在第一次和第二次 HREM 诊断之间进行了一些干预。与改善诊断相关的干预措施包括质子泵抑制剂（PPI）剂量加倍、重新开始使用 PPI、添加组胺 2 受体拮抗剂（H2 受体拮抗剂）和经验性扩张。
在本病例系列研究中，约一半的患者在至少 6 个月的时间内进行了两次食管测压检查，其最初诊断的食管运动障碍缺乏持久性。
