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首页> 外文期刊>Digestive Diseases and Sciences >Role of Diaphragmatic Crura and Lower Esophageal Sphincter in Gastroesophageal Reflux Disease: Manometric and pH-Metric Study of Small Hiatal Hernia
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Role of Diaphragmatic Crura and Lower Esophageal Sphincter in Gastroesophageal Reflux Disease: Manometric and pH-Metric Study of Small Hiatal Hernia

机译：Cru肌下颌和食管下括约肌在胃食管反流疾病中的作用：小食管裂孔疝的压力和pH计量研究

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摘要

The rapid pull-through (RPT) technique during esophageal manometry helps to identify various pressure profiles of hiatal hernia (HH), based on the presence of two high pressure zones: the diaphragmatic crura (DC) and the lower esophageal sphincter (LES). Our aim was to correlate different HH profiles with frequency of reflux episodes in patients with gastroesophageal reflux disease (GERD). Seventy-eight patients with GERD and HH underwent esophageal manometry with RPT and were grouped according to the prevalent pressure profile of HH. Twenty-four-hour pH-metry served to quantify traditional (TR) and nontraditional refluxes (drop of 1 pH unit with pH > 4 or pH < 4 and time < 5 sec) (NTR) during total, upright, and recumbent periods. The group with a prevalent “flat” HH profile, representing LES and DC impairment, had significantly more TRs in total time of reflux (P < 0.01) and in recumbent and upright periods (P < 0.05) compared to the group with a prevalence of the two pressure peaks, corresponding to LES and DC efficiency. However, the group with the flat profile had significantly more NTRs + TRs than the group with pressure peaks in total time (P < 0.01) and recumbent position (P < 0.001) but not in the upright position. Hiatal hernia predisposes to GERD, but only the associated impairment of the LES and diaphragmatic crura pressures represents a condition of high risk for gastroesophageal reflux events.
机译：食管测压期间的快速穿通（RPT）技术可根据两个高压区的存在来确定裂孔疝（HH）的各种压力分布：:肌下颌骨（DC）和食管下括约肌（LES）。我们的目标是将胃食管反流病（GERD）患者中不同的HH特征与反流发作频率相关联。七十八名GERD和HH患者接受RPT食管测压，并根据HH的普遍压力分布进行分组。二十四小时的pH量度法可用于量化传统，正常和斜卧期间的传统（TR）和非传统回流（下降1个pH单位，pH> 4或pH <4和时间<5 sec）（NTR）。与LES患儿和DC患儿相比，HH分布普遍呈“扁平”状态的组在总反流时间（P <0.01）和卧位和直立期（P <0.05）的TR明显多于P <0.05这两个压力峰值分别对应于LES和DC效率。但是，与平坦时间组相比，总时间（P <0.01）和斜卧位（P <0.001）但不处于直立位置的组的NTRs + TRs明显多于压力峰值的组。食管裂孔疝易患GERD，但仅LES和diaphragm肌横pressure膜压的相关损害表示胃食管反流事件的高风险状态。

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  • 来源
    《Digestive Diseases and Sciences》 |2001年第12期|2687-2694|共8页
  • 作者

    Rosario Cuomo; Raffaella Grasso; Giovanni Sarnelli; Dario Bruzzese; Maria Ermina Bottiglieri; Maria Alfieri; Daniel Sifrim; Gabriele Budillon;

  • 作者单位

    Dipartimento di Medicina Clinica e Sperimentale Epatogastroenterologia Università degli Studi di Napoli “Federico II”;

    Dipartimento di Medicina Clinica e Sperimentale Epatogastroenterologia Università degli Studi di Napoli “Federico II”;

    Dipartimento di Medicina Clinica e Sperimentale Epatogastroenterologia Università degli Studi di Napoli “Federico II”;

    Dipartimento di Matematica e Statistica Università degli Studi di Napoli “Federico II”;

    Unitá Operativa di Gastroenterologia ed Endoscopia Digestiva Ospedale Marcianise;

    Dipartimento di Medicina Clinica e Sperimentale Epatogastroenterologia Università degli Studi di Napoli “Federico II”;

    Department of Gastroenterology Katholieke Universiteit;

    Dipartimento di Medicina Clinica e Sperimentale Epatogastroenterologia Università degli Studi di Napoli “Federico II”;

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  • 正文语种 eng
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  • 关键词

    gastroesophageal reflux disease; hiatal hernia; esophageal manometry; pH-metry;

    机译：胃食管反流病;食管裂孔疝;食管测压;pH值测定;

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