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首页> 外文期刊>Open Journal of Gastroenterology >Semi-Solid and Solid Bolus Swallows in High-Resolution Oesophageal Manometry for the Detection of Motility Disorders
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Semi-Solid and Solid Bolus Swallows in High-Resolution Oesophageal Manometry for the Detection of Motility Disorders

机译：半固体和固体小燕子在高分辨率食管测压中用于运动障碍的检测

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Background/Aims: High-resolution oesophageal manometry utilises water swallows to evaluate oesophageal function. However, small volumes of water are not representative of normal eating and as a result often produce normal manometry studies in patients with dysphagia. This study sets out to establish optimal diagnostic thresholds for semi-solid solid swallows and evaluate their ability to uncover motility abnormalities in patients with motility disorders. Method: Manometry was performed using ten 5-mL single water swallows followed by two semi-solid and two solid swallows in the upright position. Normative values for the adjunctive tests were obtained from patient controls while patients with major motility disorders were used to establish the optimal diagnostic thresholds. Diagnostic thresholds identified were prospectively tested in patients with normal water swallows but oesophagus related symptoms and in those with minor and major motility disorders. Results: Normal values for semi-solid and solid were determined in patient controls (n = 100). Development of diagnostic thresholds included 120 patients with major motility disorders. Optimal diagnostic thresholds identified for oesophagogastric junction dysfunction in semi-solid and solid swallows (IRP > 15.5 mmHg). Hypercontractilty and spasm used existing thresholds (>8000 mmHg-s-cm and < 4.5 s, respectively) but modified frequency of ≥50% of adjunctive swallows. Diagnostic thresholds were applied to symptomatic patients with normal water swallows (n = 70) identifying 12/70 (17%) to have abnormal adjunctive swallows. One of 30 patients (3%) with ineffective motility had abnormal adjunctive swallow and 12 patients with oesophageal spasm, oesophagogastric junction obstruction, and hypercontractility had abnormal adjunctive swallows that moved them up the motility disorder hierarchy. Conclusions: Semi-solid and solid challenge increase diagnostic yield of motility disorders.
机译：背景/目的：高分辨率食管测压利用吞咽水来评估食管功能。但是，少量的水不能代表正常进食，因此经常对吞咽困难的患者进行正常的测压研究。这项研究着手建立半固体固体燕子的最佳诊断阈值，并评估其发现运动障碍患者的运动异常的能力。方法：测压法是使用十只5 mL单只水燕子，然后以直立姿势放下两只半固体和两只固体燕子。辅助测试的标准值是从患者对照中获得的，而主要运动障碍患者则用于确定最佳诊断阈值。前瞻性测试了燕子正常但有食管相关症状的患者以及轻度和重度运动障碍患者的诊断阈值。结果：在患者对照中确定半固体和固体的正常值（n = 100）。诊断阈值的发展包括120例严重运动障碍患者。确定了半固体和固体吞咽（IRP> 15.5 mmHg）中食管胃结功能异常的最佳诊断阈值。过度收缩和痉挛使用现有阈值（分别> 8000 mmHg-s-cm和<4.5 s），但修改后的吞咽频率≥50％。诊断阈值适用于吞水正常（n = 70）的有症状患者，可识别出12/70（17％）的吞咽异常。 30例运动无效的患者中（3％）有吞咽异常，12例食管痉挛，食管胃交界处阻塞和过度收缩的患者有吞咽异常，使他们进入了运动障碍体系。结论：半固体和固体挑战提高了运动障碍的诊断率。

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