胡桃夹食管患者食管动力与精神心理因素相关性研究

目的:探讨胡桃夹食管(nutcracker esophagus NE)与精神心理因素的关系。方法:使用高分辨多道灌注测压系统(PC polrrafHR瑞典产)分别对20例对照组,两组各15例胡桃夹食管患者钙拮抗剂联用和非联用抗焦虑药物的服药前后不同时段进行食管动力测定。结果:服药前两组NE食管下段蠕动波幅,食管收缩时间,食管体部运动异常检出率三项指标均高于对照组,服药后30天两组NE患者与用药前比较,三项指标测定均有显著性差异(P<0.01)。用药15d联用抗焦虑药物组的三项指标改善明显优于不联用抗焦虑药物组(P<0.01)。服药后NE组食管下段蠕动波幅、食管收缩时间和食管体部运动异常检出率与对照组比差异无显著性(P>0.05)。结论:食管下段高幅蠕动、收缩时间延长在NE发病中起重要作用,精神和心理因素是重要致病因素。治疗中不可缺少联用抗焦虑药物。

The Relative study of Esophagus Kinetic and Psychological Factor on Nutcracker Esophagus Patients

Objective: To explore the relationship between nutcracker esophagus(NE) and psychological factors.Method: The esophagus kinetic in different time was determined by using the polygraf HR manometry examination system exophageal manometry(PC polrraf HR,manufactured by Sweden)in 50 patients with nutcracker esophagus.20 cases belonged to control group.15 cases were treated with calcium antagonist and anti-anxiety drugs.15 cases were only treated with calcium antagonist.Results: Before taking the medicine,the positive rate of esophagus inferior segment peristalsis amplitude,esophagus peristalsis duration and esophagus body department motile abnormality in the two groups was obviously higher than that in control group.30 days after taking the medicine,the medicine,the three parameters were existed significant differences in the two group NE patients(P<0.01).15 days after taking the medicine,the three parameters.In the patients treated with calcium antagonist and anti-anxiety drugs were obviously better than that in the patients treated only with calcium antagonist(P<0.01).After taking the medicine,the positive rate of the three parameters in NE group was not significant when compared with control group(P>0.05).Conclusion: Esophagus motile function disorder,inferior segment peristalsis amplitude and peristalsis duration played an important role on the NE episode.Psychological factor was important inducing factor.Anti-anxiety drugs should be used in the treatment.