Patterson D R
J Clin Gastroenterol. 1982 Oct;4(5):415-7. doi: 10.1097/00004836-198210000-00005.
Many previous studies have shown diffuse esophageal spasm (DES) to be an infrequent clinical disorder. Over a 15-month period, 122 patients were evaluated by low-compliance pneumohydrolic esophageal manometry. The patients were referred for obscure undiagnosed chest pain. Diffuse esophageal spasm or its variance was found in 22 patients (18%). All patients had chest pain and 77% had associated solid and liquid food dysphagia. Medical therapy included treatment with a combination of anticholinergic medications, short- and long-acting nitrates, mild sedatives, and dietary adjustments. Follow-up clinical evaluation have been obtained in 73% of patients: medical treatment alone has been successful in impressively relieving symptoms in 10 patients, two have benefited from repeat pneumatic dilatations, and one patient has improved after pneumatic dilatation and subsequent Heller myotomy. A combination of accurate clinical history, endoscopy, barium swallow, and esophageal manometry should allow a reliable diagnosis of DES with a good chance of successful medical therapy.
许多既往研究表明，弥漫性食管痉挛（DES）是一种罕见的临床疾病。在15个月的时间里，通过低顺应性液压食管测压法对122例患者进行了评估。这些患者因不明原因的未确诊胸痛前来就诊。在22例患者（18%）中发现了弥漫性食管痉挛或其变异型。所有患者均有胸痛，77%伴有固体和液体食物吞咽困难。药物治疗包括使用抗胆碱能药物、短效和长效硝酸盐、轻度镇静剂以及饮食调整的联合治疗。73%的患者获得了随访临床评估：仅药物治疗就成功显著缓解了10例患者的症状，2例患者受益于重复气囊扩张，1例患者在气囊扩张及随后的Heller肌切开术后病情改善。准确的临床病史、内镜检查、钡餐造影和食管测压相结合，应能可靠诊断DES，并使药物治疗有很大机会取得成功。
