Richter J E, Castell D O
Ann Intern Med. 1984 Feb;100(2):242-5. doi: 10.7326/0003-4819-100-2-242.
With the renewed interest in esophageal motility disorders, diffuse esophageal spasm is being diagnosed more frequently. In many clinical settings, however, the term is used as a synonym for noncardiac chest pain. Our review of the literature and broad clinical experience in studying the motility patterns of healthy subjects have helped us better define diffuse esophageal spasm. The diagnosis of diffuse esophageal spasm should be considered only in symptomatic patients showing simultaneous contractions after wet swallows during esophageal motility testing. Simultaneous contractions should occur after at least 10% of swallows and be intermixed with normal peristaltic contractions. Repetitive waves, contractions of prolonged duration, spontaneous activity, high-amplitude contractions, and lower esophageal sphincter abnormalities may be seen in diffuse esophageal spasm. None of these findings alone or in combination justifies a diagnosis of diffuse esophageal spasm unless associated with simultaneous esophageal contractions.
随着对食管动力障碍的重新关注，弥漫性食管痉挛的诊断越来越频繁。然而，在许多临床情况下，这个术语被用作非心源性胸痛的同义词。我们对文献的回顾以及在研究健康受试者动力模式方面的广泛临床经验，帮助我们更好地定义了弥漫性食管痉挛。弥漫性食管痉挛的诊断仅应在食管动力测试中出现湿吞咽后同步收缩的有症状患者中考虑。同步收缩应在至少10%的吞咽后出现，并与正常蠕动收缩混合。弥漫性食管痉挛中可能会出现重复波、持续时间延长的收缩、自发活动、高振幅收缩以及食管下括约肌异常。除非与食管同步收缩相关，否则这些发现单独或组合起来都不能作为弥漫性食管痉挛的诊断依据。
