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利用食管动力测试诊断和评估胃食管反流病。

Utilizing Esophageal Motility Tests in Diagnosing and Evaluating Gastroesophageal Reflux Disease.

作者信息

Yang Wangliu, Huang Yurong, He Lei, Chen Dongmei, Wu Sheng, Tian Yan, Zheng Juan, Yang Jie, Song Gengqing

机构信息

Department of Gastroenterology, The Affiliated Hospital of Guizhou Medical University, Guiyang 550004, China.

Department of Gastroenterology, Liupanshui Municipal People's Hospital, Liupanshui 553000, China.

出版信息

Diagnostics (Basel). 2024 Jul 9;14(14):1467. doi: 10.3390/diagnostics14141467.

Abstract

Gastroesophageal reflux disease (GERD), a prevalent clinical condition, is often attributed to aberrant esophageal motility, leading to gastric content reflux and associated symptoms or complications. The rising incidence of GERD presents an escalating healthcare challenge. Endoscopic and esophageal reflux monitoring can provide a basis for the diagnosis of patients with gastroesophageal reflux disease, but when the diagnostic basis is at an inconclusive value, some additional supportive evidence will be needed. Advanced technology is the key to improving patient diagnosis, accurate assessment, and the development of effective treatment strategies. High-resolution esophageal manometry (HREM) and endoscopic functional lumen imaging probe (EndoFLIP) represent the forefront of esophageal motility assessment. HREM, an evolution of traditional esophageal manometry, is considered the benchmark for identifying esophageal motility disorders. Its widespread application in esophageal dynamics research highlights its diagnostic significance. Concurrently, EndoFLIP's emerging clinical relevance is evident in diagnosing and guiding the treatment of coexisting esophageal motility issues. This review integrates contemporary research to delineate the contributions of HREM, EndoFLIP, and novel technologies in GERD. It examines their efficacy in facilitating an accurate diagnosis, differentiating similar gastrointestinal disorders, quantifying the extent of reflux, assessing the severity of the disease, forecasting patient responsiveness to proton pump inhibitor therapy, and guiding decisions for surgical interventions. The overarching aim is to deepen the understanding of GERD's underlying mechanisms and advance the formulation of holistic, efficacious treatment approaches.

摘要

胃食管反流病(GERD)是一种常见的临床病症,通常归因于食管动力异常,导致胃内容物反流以及相关症状或并发症。GERD发病率的上升给医疗保健带来了日益严峻的挑战。内镜检查和食管反流监测可为胃食管反流病患者的诊断提供依据,但当诊断依据不明确时,就需要一些额外的支持性证据。先进技术是改善患者诊断、准确评估以及制定有效治疗策略的关键。高分辨率食管测压(HREM)和内镜功能管腔成像探头(EndoFLIP)代表了食管动力评估的前沿技术。HREM是传统食管测压的一种演进,被认为是识别食管动力障碍的基准。它在食管动力学研究中的广泛应用凸显了其诊断意义。与此同时,EndoFLIP在诊断和指导并存的食管动力问题治疗方面的临床相关性日益显现。本综述整合了当代研究,以阐述HREM、EndoFLIP和新技术在GERD中的贡献。它考察了它们在促进准确诊断、区分相似的胃肠道疾病、量化反流程度、评估疾病严重程度、预测患者对质子泵抑制剂治疗的反应以及指导手术干预决策方面的功效。总体目标是加深对GERD潜在机制的理解,并推动制定全面、有效的治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3c2c/11276196/f942b4bc385b/diagnostics-14-01467-g001.jpg

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