高分辨率食管测压与X线钡餐造影对食管裂孔疝诊断价值的评价

目的探究X线钡餐造影与高分辨率食管测压对食管裂孔疝的诊断价值。方法选取50例经手术确诊为食管裂孔疝患者的高分辨率食管测压与X线钡餐造影资料,对比这两种方法对食管裂孔疝的诊断价值。结果X线钡剂造影检查出食管裂孔疝48例(阳性率96%),未发现食管裂孔疝2例(阴性率4%);高分辨率食管测压检查出食管裂孔疝46例(阳性92%),未发现食管裂孔疝4例(阴性率8%);两种方法同时检查出食管裂孔疝47例,符合率94%,两种检查诊断食管裂孔疝差异无统计学意义(P>0.05)。疝囊小于3 cm时,上消化道造影诊断准确率优于高分辨率食管测压,其差异有统计学意义。高分辨测压诊断食管体部运动功能障碍21例,X线钡餐造影无特异性表现。结论X线钡餐造影与高分辨率食管测压对诊断食管裂孔疝均有较高价值,食管高分辨测压诊断食道裂孔疝合并食管体部运动功能障碍有明显优势;当疝囊较小时,上消化道造影诊断准确率优于高分辨率食管测压。

Evaluation of high resolution esophageal manometry and X-ray barium meal in the diagnosis of hiatal hernia

Objective To compare of X-ray barium meal and high resolution esophageal manometry in the diagnosis of hiatal hernia.Methods We retrospectively analysed the data of high resolution esophageal manometry and X-ray barium meal in 50 patients with hiatal hernia diagnosed by operation in xinjiang people's Hospital,and compared the diagnostic value of these two methods for hiatal hernia.Results X-ray barium radiography revealed 48 cases of hiatal hernia(positive rate of 96%).No hiatal hernia was found in 2 cases(negative rate 4%).High-resolution esophageal manometry detected 46 cases of hiatal hernia(positive rate of 92%).No hiatal hernia was found in 4 cases(negative rate 8%).47 cases of hiatal hernia were detected by two methods at the same time,the coincidence rate was 94%.There was no significant difference between the two methods in the diagnosis of hiatal hernia(P>0.05).When the hernia sac was less than 3 cm,upper gastrointestinal angiography had better diagnostic accuracy than high-resolution esophageal manometry.The difference was statistically significant,esophageal body motor dysfunction was diagnosis by high-resolution manometry in 21 cases.X-ray barium meal examination had no specific manifestation.Conclusion X-ray barium meal and high-resolution esophageal manometry are valuable in the diagnosis of hiatal hernia,high resolution esophageal manometry has obvious advantages in the diagnosis of esophageal hiatal hernia with esophageal body motor dysfunction.When the hernia sac is small,the diagnostic accuracy of upper gastrointestinal radiography is better than that of high-resolution esophageal manometry.