贲门失弛缓症气囊扩张术后测压结果与症状反应的关系。

Relationship of manometric findings to symptomatic response after pneumatic dilation in achalasia cardia.

作者信息

Shahi H M, Aggarwal R, Misra A, Agarwal D K, Naik S R

机构信息

Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.

出版信息

Indian J Gastroenterol. 1998 Jan;17(1):19-21.

PMID:9465508

Abstract

BACKGROUND

Achalasia cardia is usually treated by pneumatic dilation or surgical esophagomyotomy. The role of esophageal manometry for objective assessment of symptom response is controversial.

AIM

To study the relationship between symptoms and manometric parameters before and after pneumatic dilation in patients with achalasia cardia.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

摘要

背景

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。

目的

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。

方法

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）。

结果

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。