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出血性静脉曲张硬化治疗后的食管功能

Esophageal function after sclerotherapy of bleeding varices.

作者信息

Sauerbruch T, Wirsching R, Leisner B, Weinzierl M, Pfahler M, Paumgartner G

出版信息

Scand J Gastroenterol. 1982 Sep;17(6):745-51. doi: 10.3109/00365528209181088.

Abstract

To study the effect of sclerotherapy of varices on esophageal function, the motility of the tubular esophagus and of the lower esophageal sphincter (LES) were recorded in 19 patients after 7 to 13 sclerotherapy sessions and in 15 healthy volunteers. In addition, esophageal functional scintigraphy (EFS) was performed in the patient group. Compared with the volunteers the patients had lower contraction amplitudes in the distal esophagus (30.5 +/- 17.5 mm Hg versus 43.6 +/- 9.1 mm Hg, p less than 0.01) and a higher percentage of non-propulsive simultaneous contractions (NPC) in the distal (33.4 +/- 23.2% versus 9.0 +/- 8.6%, p less than 0.005) and mid-esophagus (15.0 +/- 8.2% versus 8.3 +/- 8.1%, p less than 0.05). There was a negative correlation between the percentage of NPC in the distal and mid-esophagus and radionuclide transit (rs - 0.53, p less than 0.02). Three of 19 patients had a positive reflux index by EFS. The LES tone was only slightly lower in the patients than in the controls (10.7 +/- 3.2 mm Hg versus 13.4 +/- 3.6 mm Hg, p less than 0.05). Our findings indicate that sclerotherapy of esophageal varices may lead to a reduced peristaltic esophageal motility with an impaired transport function. This could contribute to the development of dysphagia or esophagitis.

摘要

为研究静脉曲张硬化疗法对食管功能的影响,我们记录了19例接受7至13次硬化疗法后的患者以及15名健康志愿者的管状食管和食管下括约肌(LES)的运动情况。此外,对患者组进行了食管功能闪烁扫描(EFS)。与志愿者相比,患者远端食管的收缩幅度较低(30.5±17.5毫米汞柱对43.6±9.1毫米汞柱,p<0.01),远端(33.4±23.2%对9.0±8.6%,p<0.005)和食管中部(15.0±8.2%对8.3±8.1%,p<0.05)非推进性同步收缩(NPC)的百分比更高。远端和食管中部NPC的百分比与放射性核素通过情况呈负相关(rs=-0.53,p<0.02)。19例患者中有3例EFS反流指数为阳性。患者的LES张力仅略低于对照组(10.7±3.2毫米汞柱对13.4±3.6毫米汞柱,p<0.05)。我们的研究结果表明,食管静脉曲张硬化疗法可能导致食管蠕动功能降低,运输功能受损。这可能促使吞咽困难或食管炎的发生。

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