治疗后贲门失弛缓症患者的胸痛及食管蠕动再现

Chest pain and reappearance of esophageal peristalsis in treated achalasia.

作者信息

Papo M, Mearin F, Castro A, Armengol J R, Malagelada J R

机构信息

Digestive System Research Unit, Hospital General Vall d'Hebron, Autonomous University of Barcelona, Spain.

出版信息

Scand J Gastroenterol. 1997 Dec;32(12):1190-4. doi: 10.3109/00365529709028145.

DOI:10.3109/00365529709028145

PMID:9438314

Abstract

BACKGROUND

We wanted to evaluate the clinical significance of the esophageal peristalsis that appears in some achalasia patients after treatment.

METHODS

We prospectively investigated the reappearance of esophageal peristalsis in 106 achalasic patients treated with forceful dilatation under endoscopic control (86 metallic dilatations and 20 pneumatic dilatations) and followed up clinically and manometrically for 1 year. Patients were divided in two groups in accordance with the presence (n = 26) or persistent absence (n = 80) of postdilatation esophageal peristalsis.

RESULTS

Before treatment, clinical data and manometric findings were comparable in both groups except for esophageal wave amplitude, which was higher in patients with postdilatation peristalsis (36 +/- 5 mmHg versus 24 +/- 2 mmHg, P < 0.05). One year after dilatation manometric findings were similar in the two groups, but esophageal wave amplitude remained higher in the group with postdilatation peristalsis (46 +/- 4 mmHg versus 21 +/- 2 mmHg, P < 0.05). The proportion of patients with persistent dysphagia was similar in the two groups (15% versus 12.5%). However, 10 patients with postdilatation peristalsis (38%) complained of chest pain as opposed to only 5 patients (6%) in the group with aperistalsis (P < 0.01).

CONCLUSION

The appearance of esophageal peristalsis after forceful dilatation in achalasic patients is frequently associated with persistent or new chest pain.

摘要

背景

我们想要评估部分贲门失弛缓症患者治疗后出现的食管蠕动的临床意义。

方法

我们前瞻性地调查了106例在内镜控制下接受强力扩张治疗的贲门失弛缓症患者（86例金属扩张和20例气囊扩张）食管蠕动的再现情况，并进行了为期1年的临床和测压随访。根据扩张后食管蠕动的存在（n = 26）或持续缺失（n = 80）将患者分为两组。

结果

治疗前，两组的临床数据和测压结果具有可比性，但食管波幅除外，扩张后有蠕动的患者食管波幅更高（36±5 mmHg对24±2 mmHg，P < 0.05）。扩张后1年，两组的测压结果相似，但扩张后有蠕动的组食管波幅仍然更高（46±4 mmHg对21±2 mmHg，P < 0.05）。两组中持续吞咽困难患者的比例相似（15%对12.5%）。然而，10例扩张后有蠕动的患者（38%）主诉胸痛，而无蠕动组只有5例患者（6%）主诉胸痛（P < 0.01）。