食管裂孔疝伴胃食管反流病的胃食管动力学研究

目的:探讨食管裂孔疝(HH)伴胃食管反流病(GERD)患者与单纯HH及GERD患者之间的内镜、24h食管pH监测、食管测压、胃动力学检查之间的相关性.方法:经胃镜确诊的HH伴GERD患者61例,同期内镜确诊单纯HH患者28例,GERD患者30例,在一周内进行24h食管pH监测、食管下端括约肌(LES)压力测定及胃磁图测定胃半排空时间.结果: GERD中pH监测诊断同内镜诊断相符合占83.52%,不符合占16.48%.24h pH监测中,HH伴GERD组患者的总反流时间、卧位反流时间及立位反流时间百分比均显著高于GERD组和HH组,GERD组显著高于HH组;HH伴GERD组LESP显著低于HH组和GERD组,HH组LESP显著低于GERD组;HH伴GERD组LESL显著短于GERD组,HH伴GERD组和HH组LESL无显著差异,HH组LESL显著短于GERD组;HH伴GERD组LESR显著高于HH组和GERD组,HH组LESR显著高于GERD组;HH伴GERD组胃排空延缓者显著多于HH组,但与GERD组无显著差异,GERD组胃排空延缓者显著多于HH组.

Gastroesophageal Motility in Patients with Sliding Hiatus Hernia and Gastroesophageal Reflux Disease

Objective: To study changes in gastroesophageal motility of patients with sliding hiatus hernia(HH) and gastroesophageal reflux disease.Methods: 61 HH&GERD patients,28 HH patients and 30 GERD patients were diagnosed with gastroscopy to monitor 24-hour esophageal pH and to determine gastric half-emptying time with gastromagneticgram,and the lower esophageal sphincter(LES) pressure.Results: Among GERD,the percentage of pH monitoring diagnosis conforming to gastroesophageal diagnosis is 83.52%.16.48% does not conform to gastroeo-phageal diagnosis During 24-hour esophageal pH monitoring,the percentages of total,supine and upright acid exposure time of HH& GERD group are greater than those in GERD group and HH group.(Percentages of upright acid exposure time of HH& GERD group and upright acid exposure time of GERD group are P<0.05.Others are P<0.01) GERD group is higher than HH group remarkably(P<0.05).LESP in HH&GERD group is lower than that in HH group and GERD group(P<0.01).LESP in HH group is lower than that in GERD group(P<0.01).LESL in HH&GERD group is shorter than that in GERD group(P<0.01).LESL in HH&GERD group shows no significant differences from LESL in HH group.LESL in HH group is shorter than that in GERD group(P<0.01).LESR in HH&GERD group is higher than that LESR in HH group and in GERD group(P<0.01).LESR in HH group is higher than that in GERD group(P<0.01).Patients of gastric emptying delay in HH&GERD group are much more than those in HH group(P<0.01).Patients of gastric emptying delay in HH&GERD group show no significant differences from those in GERD group.Patients of gastric emptying delay in GERD group aremuch more than patients in HH group(P<0.01).