论文部分内容阅读
目的探讨 pH电极位置对反流性食管炎酸度监测的影响。方法 60例反流性食管炎随机分为对照 (C)组和试验 (T)组。 C组 30例用测压法将 pH电极置于下食管括约肌 (LES)上缘 5cm处； T组 30例用 pH梯度法将电极放于胃食管连接处 (GEJ)上方 5cm处。连续 24h pH监测。 结果 C与 T组前鼻孔至 GEJ平均距离 (46.2± 4.1cm与 46.5± 4.5cm)无明显差异 (P=0.8)。两组 GEJ平均距离 (46.3± 4.3cm)比 C组前鼻孔至 LES上缘平均距离 (43.3± 3.1cm)低 3.0cm(P=0.0003)。食管酸监测的 pH<4总百分时间和总计分在 T组 (8.5和 45.5)和 T组中 GEJ>LES上缘± 3cm范围者 (10.0和 99.3)，较 C组 (4.8和 26.3)均有明显增高 (P均 <0.01)，而 T组中 GEJ≤ LES上缘± 3cm范围者 (7.1和 39.4)则无明显差异 (P均 >0.05)结论因 GEJ常比 LES上缘偏低，故以 GEJ安放电极 (尤其是 GEJ>LES上缘± 3cm范围者 )对反流性食管炎行 pH监测时，这可能会扩大酸监测结果。
Objective To investigate the influence of pH electrode position on reflux esophagitis acidity monitoring. Methods Sixty reflux reflux esophagitis were randomly divided into control group (C) and experimental (T) group. In group C, pH electrodes were placed 5 cm above the upper edge of the lower esophageal sphincter (LES) by manometry; 30 patients in group T were placed 5 cm above the gastroesophageal junction (GEJ) by pH gradient method. Continuous 24h pH monitoring. Results There was no significant difference (P = 0.8) between the mean distance from anterior nostril to GEJ in C and T groups (46.2 ± 4.1cm vs 46.5 ± 4.5cm). The average GEJ distance between the two groups (46.3 ± 4.3 cm) was 3.0 cm (P = 0.0003) lower than the average distance between the anterior nostril of group C and the upper edge of LES (43.3 ± 3.1 cm). Esophageal acid monitoring of pH <4 total percentage and total score in the T group (8.5 and 45.5) and T group in the upper edge of GEJ> LES ± 3cm range (10.0 and 99.3), compared with the C group (4.8 and 26.3) (P <0.01), while there was no significant difference in T group between the upper edge of GEJ≤LES ± 3cm (7.1 and 39.4) (all P> 0.05) .Conclusion Because GEJ is often lower than the upper edge of LES, When pH monitoring of reflux esophagitis with GEJ placement electrodes (especially those with a GEJ> LES upper edge of ± 3 cm) may increase the acid monitoring results.