食管钡餐造影足够吗？食管高分辨率测压与钡餐造影发现的食管动力比较。
Is barium esophagram enough? Comparison of esophageal motility found on barium esophagram to high resolution manometry.
机构信息
Spectrum Health Medical Group Department of Surgery, Michigan State University School of Medicine, United States.
Spectrum Health Medical Group Department of Surgery, Michigan State University School of Medicine, United States.
出版信息
Am J Surg. 2021 Mar;221(3):575-577. doi: 10.1016/j.amjsurg.2020.11.028. Epub 2020 Nov 17.
BACKGROUND
The aim of the study is to determine if barium esophagram (BE) alone is sufficient to diagnose esophageal dysmotility when compared to the gold standard, high-resolution manometry (HRM).
METHODS
This is a retrospective review of patients that underwent laparoscopic fundoplication by two surgeons at a single institution from 10/1/2015-6/29/2019. Patients with large paraesophageal hernias and patients without both BE and HRM were excluded.
RESULTS
Forty-six patients met the inclusion criteria. BE was found to be concordant with HRM for esophageal motility in only 21 patients (46%). Setting HRM as the gold standard, BE had a sensitivity of 14% (95% CI: 5%-35%), specificity of 72% (95% CI: 52%-86%), PPV of 30% (95% CI: 11%-60%), and NPV of 50% (95% CI: 35%-66%). The accuracy was 46%, while a McNemar test showed p = 0.028.
CONCLUSION
Traditional BE should not be used in place of HRM for assessing pre-operative motility in patients undergoing anti-reflux surgery.
背景
本研究旨在比较钡餐食管造影（BE）与金标准高分辨率测压（HRM），确定 BE 是否足以诊断食管动力障碍。
方法
这是对 2015 年 10 月 1 日至 2019 年 6 月 29 日期间在一家机构由两位外科医生进行腹腔镜胃底折叠术的患者进行的回顾性研究。排除了存在巨大食管裂孔疝和仅有 BE 而无 HRM 的患者。
结果
46 名患者符合纳入标准。仅 21 名患者（46%）的 BE 与 HRM 对食管动力的诊断结果一致。以 HRM 为金标准，BE 的敏感性为 14%（95%CI：5%-35%），特异性为 72%（95%CI：52%-86%），PPV 为 30%（95%CI：11%-60%），NPV 为 50%（95%CI：35%-66%）。准确性为 46%，McNemar 检验显示 p=0.028。
结论
在抗反流手术前评估患者的运动功能时，不应使用传统的 BE 代替 HRM。
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