食管动力学及24小时食管pH监测在胸痛诊断中的意义

目的探讨食管动力学、24小时食管pH及24小时动态心电图监测对反复发作性胸痛的诊断价值. 方法对46例反复发作胸痛的患者进行食管动力学检测、24小时食管pH及24小时动态心电图监测,根据检查结果,给予相应治疗,并观察近期效果.结果 46例患者中发现非特异性食管功能障碍24例,其中伴有胃食管反流14例、心肌缺血4例;贲门失弛缓症5例,其中伴有胃食管反流1例;弥漫性食管痉挛4例,其中伴有胃食管反流4例、心肌缺血2例;胡桃夹食管(nutcracker esophagus)1例.结论对反复发作性胸痛患者联合食管测压、24小时食管pH和24小时动态心电图监测有助于食管源性及心源性胸痛的诊断,而且对其鉴别诊断亦有帮助.

The significance of esophageal motility testing and 24-hour esophageal pH monitoring in the diagnosis of chest pain

Objective To explore the significance of esophagea l motility testing, 24-hour esophageal pH monitoring and Holter monitoring electrocardiogram in t h e diagnosis of chest pain. Methods Forty-six patients with re peated chest pain admitted in our department were examined with esophageal mot ility testing, 24-hour esophageal pH monitoring and Holter monitoring electroca rdiogram. The patients were treated according to the results and then re-examin e d. Results Twenty-four cases with nonspe cific esophageal motility disorders (14 cases with gastroesophageal reflux and 4 cases with my ocardial ischemia), 5 cases with achalasia of cardia (1 case with gastroesoph ageal reflux), 4 cases with diffuse spasm of esophagus(4 cases with gastroesop hageal reflux and 2 cases with myocardial ischemia), and 1 case with nutcracker esophagus were found. Conclusion Esophageal motility testing, 24-hour esophageal pH monitoring and Holter monitoring electrocardiogram are im portant and helpful in the diagnosis and differential diagnosis of chest pain.