非梗阻性食管源性吞咽困难患者食管测压结果分析

背景:食管源性吞咽困难的病因可分为机械性梗阻和动力障碍两类。目前关于致吞咽困难的食管动力障碍类型的研究相对较少。目的:分析非梗阻性食管源性吞咽困难患者的食管测压结果,探讨引起吞咽困难症状的常见食管动力障碍类型。方法:纳入2007年1月～2012年6月西安交通大学医学院第二附属医院50例以吞咽困难为主诉而行食管测压者,对其测压结果进行分析。入组患者通过病史询问、内镜或食管钡透检查等除外非食管源性和梗阻性吞咽困难。结果:36例(72.0%)患者的食管动力障碍类型为非特异性食管动力障碍(NEMD),13例(26.0%)为贲门失弛缓症,1例(2.0%)食管测压结果正常。9例(18.0%)合并胃食管反流病者均为NEMD。NEMD和贲门失弛缓症患者的食管动力障碍均以食管体部运动功能紊乱和下食管括约肌功能异常为主。结论:本组非梗阻性食管源性吞咽困难患者的食管动力障碍类型多为NEMD,其次为贲门失弛缓症。非梗阻性食管源性吞咽困难患者的食管测压结果可能正常。

Assessment of Esophageal Manometry in Patients with Nonobstructive Esophageal Dysphagia

Background： Esophageal dysphagia may result from mechanical obstruction and dysmotility, however, studies focusing on types of esophageal dysmotility in dysphagia patients are relatively scarce. Aims： To analyze the results of esophageal manometry in patients with nonobstruetive esophageal dysphagia and to study the common types of esophageal dysmotility that cause dysphagia. Methods ： The results of esophageal manometry of 50 dysphagia patients from Jan. 2007 to Jun. 2012 at The Second Affiliated Hospital of Medical College of Xi＇ an Jiaotong University were analyzed. Patients suffered from non-esophageal or obstructive dysphagia were excluded through history inquiry, endoscopy, barium examination and other necessary examinations. Results： Nonspecific esophageal motility disorder （NEMD） was diagnosed in 36 patients （72.0%） , 13 patients （26.0%） were diagnosed as esophageal achalasia, and 1 patient （2.0%） had normal manometric result. All 9 cases （ 18.0% ） combined with gastroesophageal reflux disease were NEMD. Malfunction of esophagus mainly occurred in esophageal body and lower esophageal sphincter in both NEMD and aehalasia patients. Conclusions： NEMD is the most common esophageal dysmotility in patients with nonobstructive esophageal dysphagia, followed by achalasia. Esophageal manometric result might be normal in patients with nonobstructive esophageal dysphagia.