食管胃流出道梗阻患者病因及不同亚组食管动力特点分析

徐甜甜; 王嘉麟; 唐小波; 巩波

doi:10.3969/j.issn.1671-038X.2021.07.09

食管胃流出道梗阻患者病因及不同亚组食管动力特点分析

- 1. 惠州市第三人民医院消化内科(广东惠州, 516002);
- 2. 惠州市第三人民医院胃肠外科

详细信息

通讯作者: 徐甜甜,E-mail:xyxgk1123@163.com

中图分类号: R735.1

收稿日期: 2021-03-03

Etiological investigation of patients with esophageal and gastric outflow tract obstruction and analysis of esophageal dynamic characteristics in different subgroups

- 1. Department of Gastroenterology, Huizhou Third People's Hospital, Huizhou, 516002, China;
- 2. Department of Gastrointestinal Surgery, Huizhou Third People's Hospital

More Information

Corresponding author: XU Tiantian, E-mail: xyxgk1123@163.com

Received Date: 03 March 2021

摘要

摘要: 目的：研究食管胃流出道梗阻（EGJOO）患者的病因及不同亚组食管动力的特点并予以分析。方法：回顾性分析2018年2月1日-2020年1月1日收治的240例EGJOO患者的临床病历资料。分别完善所有受试者的胃镜、心电图、腹部B超以及胸部X线片检查，对病因不明的受试者完善24 h pH-阻抗监测以及胸腹部CT检查等，明确所有受试者的病因。将所有EGJOO患者按照病因的差异分作解剖异常性EGJOO（A-EGJOO）组以及功能性EGJOO（F-EGJOO）组，分析2组受试者食管动力参数的差异。结果：240例患者临床症状按照占比从高到低的顺序分别为胸痛（胸骨后不适）、吞咽困难、烧心（反酸）以及其他症状，占比分别为31.25%、28.75%、26.25%、13.75%。240例患者病因按照占比从高到低的顺序分别为非糜烂性反流病、反流性食管炎、食管胃交界部其他良性病变、结缔组织病变、食管胃交界部恶性肿瘤，占比分别为33.75%、18.75%、16.25%、6.25%、5.00%。A-EGJOO组食团内压为（6.79±1.75） mmHg，高于F-EGJOO组的（5.07±1.22） mmHg（P<0.05）；而2组其余各项食管动力学参数对比均差异无统计学意义（P>0.05）。结论：EGJOO患者临床症状多见胸痛（胸骨后不适）、吞咽困难以及烧心（反酸）等，常见病因为非糜烂性反流病、反流性食管炎以及食管胃交界部其他良性病变等。A-EGJOO患者的食团内压相对F-EGJOO患者更高，可能有助于不同亚组EGJOO患者的鉴别诊断。
- 食管胃流出道梗阻 /
- 食管动力学 /
- 食团内压 /
- 贲门失弛缓症
Abstract: Objective: To investigate the etiology of esophageal and gastric outflow tract obstruction(EGJOO) and to analyze the characteristics of esophageal dynamics in different subgroups. Methods: The clinical medical records of 240 patients with EGJOO admitted to our hospital from February 1, 2018 to January 1, 2020 were retrospectively analyzed. Gastroscopy, ECG, abdominal B-ultrasound and chest X-ray examinations of all subjects were completed, and 24 h pH-impedance monitoring and chest and abdominal CT examinations were completed for subjects with unknown etiology to determine the etiology of all subjects. In addition, all EGJOO patients were divided into anatomic abnormal EGJOO(A-EGJOO) group and functional EGJOO(F-EGJOO) group according to etiological differences. The differences of esophageal dynamic parameters between the two groups were analyzed. Results: The clinical symptoms of 240 patients were chest pain/retrosternal discomfort, dysphagia, heartburn/acid reflux and other symptoms in the order of proportion from high to low, accounting for 31.25%, 28.75%, 26.25%, 13.75%. The etiology of the 240 patients was non-erosive reflux disease, reflux esophagitis, other benign lesions at the esophagogastric junction, connective tissue lesions, and malignant tumor of the esophagogastric junction book, accounting for 33.75%, 18.75%, 16.25%, 6.25%, 5.00%, respectively. The internal pressure of food mass in A-EGJOO group was(6.79±1.75) mmHg, which was higher than that in F-EGJOO group(5.07±1.22) mmHg(P<0.05). Other esophageal dynamic parameters were not significantly compared between the two groups(P>0.05). Conclusion: The clinical symptoms of EGJOO patients are mostly chest pain/retrosternal discomfort, dysphagia, heartburn/acid reflux, etc., and the common causes are non-erosive reflux disease, reflux esophagitis and other benign lesions at the esophagogastric junction. Patients with A-EGJOO had higher internal pressure in their pellets than those with F-EGJOO, which may contribute to the differential diagnosis of patients with different subgroups of EGJOO.
- esophageal and gastric outflow tract obstruction /
- etiological investigation /
- internal pressure of pellet /
- achalasia of cardia

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