不同体位高分辨率食管测压检测下食管括约肌静息压的比较分析

目的 了解不同体位对临床高分辨率食管测压检测下食管括约肌静息压力（LESP）结果的影响.方法 对临床有检查适应证的40例患者行高分辨率测压（HRM）,按照性别、年龄、疾病进行分组比较,分析坐位及平卧位LESP的差异.结果 受检患者下食管括约肌（LES）上缘及下缘距鼻孔平均距离为（42.8±3.3）cm和（45.6±3.7）cm,LES长度为（2.8±0.8）cm.根据受检患者身高分组,组间食管括约肌位置及长度比较差异无统计学意义（P＞0.05）.不同性别患者其平卧位及坐位LESP差异无统计学意义（P＞0.05）.随着年龄的增加,LESP逐渐降低,但体位对其无明显影响.反流性食管炎患者平卧位LESP为（9.38 ±2.95） mmHg,坐位LESP为（11.35±4.09） mmHg,两者比较差异有统计学意义（P＜0.05）;贲门失迟缓症患者平卧位LESP为（46.40±1.13） mmHg,坐位LESP为（43.78±2.38） mmHg,两者比较差异有统计学意义（P＜0.05）.非糜烂性胃食管反流病（NERD）及无明确食管疾病患者不同体位LESP比较差异无统计学意义（P＞0.05）.结论 临床中应根据患者症状采用不同体位进行检查,以增加疾病诊断的敏感性.

Comparative analysis of LESP with high-resolution manometry in different positions

Objective To investigate the effects of lower esophageal sphincter pressure （LESP） with high-resolution manometry （HRM） in different positions. Methods A total of 40 patients were tested with 36-channel HRM. Results of LESP were analyzed in sitting and supine position. Results The aver- age distance from the upper edge and the lower edge of lower esophageal sphincter （LES） to nose were （42.8 ±3.3 ） cm and （ 45.6 ± 3.7 ） cm, respectively. The length of LES was （ 2.8 ±0.8 ） cm. There were no significant differences in the length or position of LES among different height groups of the patients. In addition, there were no significant differences in sitting and supine position of LESP between males and fe- males. With the increasing of age, LESP decreased gradually. In patients with reflux esophagitis, LESP was significantly lower in supine position than in sitting position. In patients with aehalasia, LESP was signifi- candy higher in supine position than in sitting position. There were no significant differences in the pa- tients with non-erosive reflux disease or without definite esophageal disease. Conclusion In order to in- crease the sensitivity of diagnosis in esophageal disease, LESP in different positions should be tested according to the patients＇ symptoms