Shahi H M, Aggarwal R, Misra A, Agarwal D K, Naik S R
Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.
Indian J Gastroenterol. 1998 Jan;17(1):19-21.
Achalasia cardia is usually treated by pneumatic dilation or surgical esophagomyotomy. The role of esophageal manometry for objective assessment of symptom response is controversial.
To study the relationship between symptoms and manometric parameters before and after pneumatic dilation in patients with achalasia cardia.
Sixteen patients with achalasia cardia underwent esophageal manometry before and after undergoing pneumatic dilation. At each time, lower esophageal sphincter (LES) pressure and mean basal esophageal-gastric pressure gradient (MIEP-MIGP) were measured.
Good symptom response was obtained in 12 of 16 patients. Median (range) LES pressure fell from 42 (17-51) mmHg to 18 (8-39) mmHg in those patients with a good response, and from 51 (25-68) mmHg to 29.5 (23-42) mmHg in those who responded poorly. Mean intraesophageal pressure fell below mean intragastric pressure in both the groups.
Esophageal manometry does not correlate with symptom improvement after pneumatic dilation in achalasia cardia. Dysphagia may persist in spite of reversal of the MIEP-MIGP gradient.
贲门失弛缓症通常采用气囊扩张术或手术食管肌层切开术进行治疗。食管测压在客观评估症状反应中的作用存在争议。
研究贲门失弛缓症患者气囊扩张术前、后症状与测压参数之间的关系。
16例贲门失弛缓症患者在接受气囊扩张术前、后均接受了食管测压。每次测量时，均测定食管下括约肌（LES）压力和平均基础食管-胃压力梯度（MIEP-MIGP）。
16例患者中有12例症状得到良好缓解。症状缓解良好的患者中，LES压力中位数（范围）从42（17 - 51）mmHg降至18（8 - 39）mmHg，症状缓解不佳的患者中，LES压力中位数从51（25 - 68）mmHg降至29.5（23 - 42）mmHg。两组患者的平均食管内压力均低于平均胃内压力。
贲门失弛缓症患者气囊扩张术后，食管测压结果与症状改善情况不相关。尽管MIEP-MIGP梯度逆转，但吞咽困难仍可能持续存在。
