共查询到20条相似文献,搜索用时 125 毫秒
1.
麻荣武 《实用心脑肺血管病杂志》2009,17(7):594-595
目的探讨胃食管反流病误诊原因,提出防范误诊措施。方法对48例胃食管反流病误诊资料进行回顾性分析。结果48例患者主要表现为咽痛、清咽、咽部阻塞感、咽不适感等胃肠外症状。喉镜检查均见咽喉部黏膜充血、水肿、咽后壁有淋巴小结增生。经胃镜检查、诊断性治疗诊断胃食管反流病。给予质子泵抑制剂及促胃动力药。结论部分胃食管反流病以咽喉症状为主要表现,易误诊为咽喉疾病,应仔细鉴别胃食管反流病,行胃镜检查或24h食管PH值测定及其他寻找胃食管反流证据的检查、给予质子泵抑制剂诊断性治疗,有助于正确诊断。 相似文献
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胃-食管反流病的咽喉部表现 总被引:3,自引:0,他引:3
胃-食管反流病被认为是喉部病变的病因之一,其与咽喉部症状之间的关系日益受到重视。本文就反流性咽喉炎的发病机制、临床特征、实验室检查、诊断和治疗等方面作一简要综述。 相似文献
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胃和 (或 )十二指肠内容物反流入食管产生症状或并发症时 ,称为胃食管反流病 (GERD)。十二指肠内容物经幽门反流入胃内称为十二指肠胃反流 (DGR) ,如进一步反流入食管则形成十二指肠胃食管反流(DGER) ,若反流量大、频率高、持续时间长 ,则可能引起病理性损害。现就十二指肠胃食管反流的病因和致病机制、临床意义、检测方法及防治措施作以下综述。 十二指肠胃食管反流的病因和致病机制若发生十二指肠胃食管反流则首先要有十二指肠胃反流 ,许多结构或功能紊乱均可引起十二指肠胃反流 ,如胃部分切除术后、胃十二指肠运动异常、胆… 相似文献
4.
食管静脉曲张套扎术对胃食管酸反流影响初步研究 总被引:1,自引:0,他引:1
食管静脉曲张套扎术对胃食管酸反流影响初步研究吴俊超林世富王一平杨丽李朝瑛食管静脉曲张套扎术在其治疗和预防中取得了较好的效果,为了解套扎术对胃食管酸反流影响,采用24小时pH监测32例肝硬化食管静脉曲张患者套扎术前后食管pH动态变化,并分析其意义。材料... 相似文献
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胆汁反流检测在胃食管反流病中的意义 总被引:9,自引:1,他引:8
目的 研究食管胆汁反流的发生情况,探讨其与酸、碱反流的关系及其对胃食管反流病(GERD)的诊断意义。方法 应用便携式24小时pH监测仪及胆汁监测仪同步检测反流性食管炎(RE)、胃切除术后者及健康志愿者共34例的食管内24小时pH变化及胆汁反流情况。结果 RE组食管酸暴露时间比对照组及胃手术后组均显著增加。各组间pH〉8总时间百分比结果相似,均较低。食管胆汁反流用胆红素吸收值≥0.14的时间百分比表 相似文献
8.
胃食管反流病是消化内科常见病。近年来,24 h多通道腔内阻抗联合p H技术的运用将反流事件分为酸反流、弱酸反流及弱碱反流。本文将这3种类型反流的定义、引起胃食管反流病的机制及治疗综述如下。 相似文献
9.
目的 探讨特发性肺纤维化(IPF)与胃食管反流的相关性,分析其临床特点.方法 选2011年1月至2013年10月中国医科大学附属第一医院住院或门诊IPF患者25例(IPF组),另选非IPF的间质性肺疾病患者23例作对照(非IPF组),两组患者行24 h食管pH值监测,分析胃食管反流特点及其临床特征.结果 胃食管反流阳性IPF组16例,非IPF组8例.IPF组DeMeester评分高于非IPF组,差异有统计学意义[(22.8±21.5)分比(15.7±14.0)分;P<0.05].IPF组长反流(反流时间持续>5 min)次数[(3.8±4.1)次]、反流指数(1.8±1.7)高于非IPF组[(2.1±2.1)次;1.3±1.2],但差异无统计学意义.IPF胃食管反流阳性者合计反流时间百分比(pH <4.0)[(9.2±5.1)%]、直立位反流时间百分比[(8.5±5.2)%]、仰卧位反流时间百分比[(10.8±10.7)%]、反流次数[(54.2±22.7)次]、长反流次数[(6.3±4.2)次]、最长反流时间[(14.5±15.3) nin]、反流指数(2.5±1.7)和DeMeester评分[(34.9±20.3)分]明显高于阴性者,差异有统计学意义(P值均<0.05).DeMeester评分与胃食管反流病问卷(GerdQ)评分呈正相关(r=0.667,P<0.01).IPF患者胃食管反流阳性者典型胃食管反流症状:烧心7例,反流6例,多于胃食管反流阴性者(烧心2例,反流1例).结论 IPF患者胃食管反流阳性率高,但往往缺少典型的胃食管反流症状.在不具备胃酸监测条件的医院,GerdQ可用于评价IPF患者是否存在胃食管反流. 相似文献
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胃食管反流病是一种胃内容物反流引起不适症状和(或)并发症的一种疾病,其发病与食管下括约肌(inferior esophageal sphincter,LES)一过性松弛、食管酸清除功能障碍以及食管抗反流屏障下降等机制有关。研究表明,胃内酸袋的存在亦为导致胃食管反流病发生的机制之一。本文就胃内酸袋与胃食管反流病的关系作一综述。 相似文献
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Aguero GC Lemme EM Alvariz A Carvalho BB Schechter RB Abrahão L 《Arquivos de gastroenterologia》2007,44(1):39-43
BACKGROUND: Respiratory, ear-nose and throat complaints, chest pain and dysphagia can be a part of clinical manifestations of gastroesophageal reflux disease. The first two are named supraesophageal manifestations of gastroesophageal reflux disease. Controversy about the prevalence of these clinical manifestations in patients with non-erosive and erosive gastroesophageal reflux disease exists. AIMS: Evaluate the prevalence of supraesophageal manifestations in patients with erosive and non-erosive gastroesophageal reflux disease. METHODS: Files from patients submitted to upper endoscopy, esophageal manometry and pH monitoring for the investigation of gastroesophageal reflux disease (heartburn as the chief complaint) were reviewed and respiratory and ear, nose and throat symptoms were recorded. Patients with erosive disease (grades I to III according to Savary-Miller classification) and with non-erosive disease (normal endoscopy with abnormal pH monitoring were selected. Statistical analysis included the chi-square test. RESULTS: Two hundred and eighty patients fulfilled the inclusion criteria being 162 with erosive disease (70% with grade I esophagitis) and 118 with non-erosive disease. Overall, 88 patients had ear, nose and throat symptoms (31%), the more frequent were hoarseness and clearing and 42, respiratory manifestations (15%), being cough the more prevalent. In the ear, nose and throat symptoms group, 45 were erosive disease (28%) and 43 non-erosive disease (36.4%). As for the respiratory symptom group, 21 patients (13%) were erosive disease and 21 (18%) were non-erosive disease. CONCLUSION: There was no difference in the prevalence of supraesophageal manifestations between patients with gastroesophageal erosive and non-erosive reflux disease. 相似文献
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非糜烂性反流病的治疗进展 总被引:2,自引:0,他引:2
胃食管反流病(GERD)一直是胃肠病学专家研究的热点,近年来逐渐认识到非糜烂性反流病与糜烂性反流病是GERD的两种不同亚型,其临床特征和治疗均存在一定程度的差异,且非糜烂性反流病较糜烂性反流病更难以完全治愈,本文就近年来非糜烂性反流病的治疗进展作一概述。 相似文献
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Vaezi MF 《Nature clinical practice. Gastroenterology & hepatology》2005,2(12):595-603
Gastroesophageal reflux disease has been increasingly associated with ear, nose and throat signs and symptoms; however, the cause and effect relationship between these two clinical entities is far from established. Many patients initially diagnosed with gastroesophageal reflux disease as the cause of laryngeal signs do not respond either symptomatically or laryngoscopically to aggressive acid suppression, and do not have abnormal esophageal acid exposure as measured by pH monitoring. This has resulted in frustration on the part of both gastroenterologists and ear, nose and throat physicians, and confusion on the part of patients. This review discusses the reasons for this controversy and highlights data that attempt to clarify this complex area. 相似文献
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Taner Y?lmaz Münir Demir Bajin R?za ?nder Günayd?n Serdar ?zer Tevfik S?zen 《World journal of gastroenterology : WJG》2014,20(27):8964-8970
Laryngopharyngeal reflux (LPR) occurs when gastric contents pass the upper esophageal sphincter, causing symptoms such as hoarseness, sore throat, coughing, excess throat mucus, and globus. The pattern of reflux is different in LPR and gastroesophageal reflux. LPR usually occurs during the daytime in the upright position whereas gastroesophageal reflux disease more often occurs in the supine position at night-time or during sleep. Ambulatory 24-h double pH-probe monitoring is the gold standard diagnostic tool for LPR. Acid suppression with proton pump inhibitor on a long-term basis is the mainstay of treatment. Helicobacter pylori (H. pylori) is found in many sites including laryngeal mucosa and interarytenoid region. In this paper, we aim to present the relationship between LPR and H. pylori and review the current literature. 相似文献
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Pim W. Weijenborg Albert J. Bredenoord 《Best Practice & Research: Clinical Gastroenterology》2013,27(3):353-364
In gastroesophageal reflux disease (GERD) symptoms arise due to reflux of gastric content into the oesophagus. However, the relation between magnitude and onset of reflux and symptom generation in GERD patients is far from simple; gastroesophageal reflux occurs several times a day in everyone and the majority of reflux episodes remains asymptomatic. This review aims to address the question how reflux causes symptoms, focussing on factors leading to enhanced reflux perception. We will highlight esophageal sensitivity variance between subtypes of GERD, which is influenced by peripheral sensitization of primary afferents, central sensitization of spinal dorsal horn neurons, impaired mucosal barrier function and genetic factors. We will also discuss the contribution of specific refluxate characteristics to reflux perception, including acidity, and the role of bile, pepsin and gas and proximal extent. Further understanding of reflux perception might improve GERD treatment, especially in current partial responders to therapy. 相似文献
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Rui-Hua Wang 《World journal of gastroenterology : WJG》2015,21(17):5210-5219
The occurrence of gastroesophageal reflux disease is common in the human population.Almost all cases of esophageal adenocarcinoma are derived from Barrett's esophagus,which is a complication of esophageal adenocarcinoma precancerous lesions.Chronic exposure of the esophagus to gastroduodenal intestinal fluid is an important determinant factor in the development of Barrett's esophagus.The replacement of normal squamous epithelium with specific columnar epithelium in the lower esophagus induced by the chronic exposure to gastroduodenal fluid could lead to intestinal metaplasia,which is closely associated with the development of esophageal adenocarcinoma.However,the exact mechanism of injury is not completely understood.Various animal models of the developmental mechanisms of disease,and theoretical and clinical effects of drug treatment have been widely used in research.Recently,animal models employed in studies on gastroesophageal reflux injury have allowed significant progress.The advantage of using animal models lies in the ability to accurately control the experimental conditions for better evaluation of results.In this article,various modeling methods are reviewed,with discussion of the major findings on the developmental mechanism of Barrett's esophagus,which should help to develop better prevention and treatment strategies for Barrett's esophagus. 相似文献
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GERD is a common chronic gastrointestinal disorder, and its prevalence in Asia is increasing. Classical symptoms of heartburn
and regurgitation are common presentations. There is no standard criterion for the diagnosis of GERD, and 24-h pH monitoring
lacks sensitivity in NERD. Furthermore, diagnostic studies for gastroesophageal reflux disease have several limitations. A
short course of PPI is often used in clinical practice as a diagnostic test for gastroesophageal reflux disease. Elderly patients
with GERD usually present with atypical manifestations, and they tend to develop more severe disease. PPI remains the mainstay
of treatment for GERD. In a subset of patients who wish to discontinue maintenance treatment, anti-reflux surgery is a therapeutic
option. 相似文献
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Irene Martinucci Nicola de Bortoli Maria Giacchino Giorgia Bodini Elisa Marabotto Santino Marchi Vincenzo Savarino Edoardo Savarino 《World journal of gastrointestinal pharmacology and therapeutics》2014,5(2):86-96
Esophageal motility abnormalities are among the main factors implicated in the pathogenesis of gastroesophageal reflux disease. The recent introduction in clinical and research practice of novel esophageal testing has markedly improved our understanding of the mechanisms contributing to the development of gastroesophageal reflux disease, allowing a better management of patients with this disorder. In this context, the present article intends to provide an overview of the current literature about esophageal motility dysfunctions in patients with gastroesophageal reflux disease. Esophageal manometry, by recording intraluminal pressure, represents the gold standard to diagnose esophagealmotility abnormalities. In particular, using novel techniques, such as high resolution manometry with or without concurrent intraluminal impedance monitoring, transient lower esophageal sphincter (LES) relaxations, hypotensive LES, ineffective esophageal peristalsis and bolus transit abnormalities have been better defined and strongly implicated in gastroesophageal reflux disease development. Overall, recent findings suggest that esophageal motility abnormalities are increasingly prevalent with increasing severity of reflux disease, from nonerosive reflux disease to erosive reflux disease and Barrett's esophagus. Characterizing esophageal dysmotility among different subgroups of patients with reflux disease may represent a fundamental approach to properly diagnose these patients and, thus, to set up the best therapeutic management. Currently, surgery represents the only reliable way to restore the esophagogastric junction integrity and to reduce transient LES relaxations that are considered to be the predominant mechanism by which gastric contents can enter the esophagus. On that ground, more in depth future studies assessing the pathogenetic role of dysmotility in patients with reflux disease are warranted. 相似文献
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非糜烂性反流病(NERD)是胃食管反流病(GERD)的一个亚型,其病理生理学机制复杂且目前对其认识存在争议.直接造成了临床上没有清晰的标准可指导医疗实践。本文重点对NERD主要临床症状的病理生理学机制,如胃十二指肠内容物反流、食管上皮细胞间隙增宽、内脏高敏感.炎症因素、心理因素等作一综述。 相似文献