- 期刊
Esophageal Dysmotility in Patients with Non-obstructive Dysphagia: Studies Using Combined Manometry and Impedance
應用食道電阻力測量併食道動力儀探討非阻礙性吞嚥困難之食道蠕動
摘要
本研究目的是評估與描述非阻礙性吞嚥困難患者的食道蠕動和食團運送。我們連續對18名非阻礙性吞嚥困難患者與14名健康受試者實施多通道食道電阻力及食道動力儀檢查。如果遠端食道收縮強度低於30mmHg或是食道同時收縮，則判定爲蠕動異常。如果在一個以上的電阻力測量部位沒有發現食團通過，則判定爲食團運送異常。在吞嚥液體和黏稠物時，健康受試者的食道正常蠕動比非阻礙性吞嚥困難患者的發生率較高(P=0.001)。非阻礙性吞嚥困難患者的完整食團運送發生率較健康受試者低(P=0.001)。在40%的食道動力儀正常患者及38%食道動力儀異常患者身上，可以發現液體食團運送異常，而在38%的食道動力儀正常患者及70%食道動力儀異常患者身上，可觀察到黏稠物食團運送異常。多通道食道電阻測量可進一步確認傳統食道動力儀所無法偵測的食團運送異常。結合多通道食道電阻力併食道動力儀在臨床上可協助偵測非阻礙性吞嚥困難患者的食道蠕動異常。
並列摘要
This study aimed to assess and characterize esophageal motility and bolus transport in patients with non-obstructive dysphagia (NOD). Combined esophageal manometry and impedance was performed in 18 consecutive NOD patients and 14 healthy controls. Esophageal peristalsis was abnormal if the amplitude of distal esophageal contractions was less than 30 mmHg or simultaneous contractions occurred. Bolus transit was abnormal if bolus exit was not found at one or more of the measuring sites. The prevalence of normal peristalsis was greater in healthy controls than in NOD patients during liquid (91% vs. 51%, P=0.001) and viscous swallows (83% vs. 49%, P=0.001). The prevalence of complete bolus transit was lower in NOD patients compared to healthy controls during liquid (73% vs. 95%, P=0.001) and viscous swallows (57% vs. 85%, P=0.001). Abnormal liquid bolus transit was found in 40% of patients with normal motility (manometry) and 38% of patients with abnormal motility (manometry), whereas abnormal viscous bolus transit was observed in 38% of patients with normal motility (manometry) and 70% of patients with abnormal motility (manometry). Multiple intraluminal impedance helps identify bolus transit abnormalities not detected by conventional manometry. Combined multiple intraluminal impedance and esophageal manometry is clinically useful for detecting esophageal dysmotility in patients with NOD.
延伸閱讀
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