High-resolution manometry in clinical practice: utilizing pressure topography to classify oesophageal motility abnormalities.
High-resolution manometry in clinical practice: utilizing pressure topography to classify oesophageal motility abnormalities.
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DOI：
10.1111/j.1365-2982.2009.01311.x
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发表时间：
2009-08
影响因子：
3.5
通讯作者：
Kahrilas PJ
中科院分区：
文献类型：
--
作者：
Pandolfino JE;Fox MR;Bredenoord AJ;Kahrilas PJ
能够监测从咽部到胃的压力以及压力地形图的高分辨率测压法代表了食管测压法无可争议的发展。然而，这项先进技术也带来了挑战，其中之一就是设计最佳方案，将高分辨率食管压力地形图 (HROPT) 应用于患者的临床评估。芝加哥分类的第一次迭代基于对 75 名对照受试者和 400 名连续患者的运动模式的系统分析。这篇评论总结了分析过程的演变。使用现已为 HROPT 定制的指标，以逐步的方式分析单个吞咽的食管胃连接部 (OGJ) 的形态、OGJ 松弛的程度、蠕动的传播速度、蠕动收缩的强度以及推注内压力的异常。然后将这些结果综合为综合诊断，该诊断虽然基于传统的测压标准，但也针对 HROPT 测量进行了定制。由此产生的分类客观化了贲门失弛缓症三种独特亚型的识别。此外，它还提供了对远端食管痉挛、胡桃夹食管亚型和 OGJ 梗阻的详细描述。我们期望该分类方案的修改将继续进行，这将进一步阐明压力地形图在评估食管动力障碍中的效用。
High-resolution manometry capable of pressure monitoring from the pharynx to the stomach together with pressure topography plotting represents an unquestionable evolution in oesophageal manometry. However, with this advanced technology come challenges and one of those is devising the optimal scheme to apply high-resolution oesophageal pressure topography (HROPT) to the clinical evaluation of patients. The first iteration of the Chicago classification was based on a systematic analysis of motility patterns in 75 control subjects and 400 consecutive patients. This review summarizes the analysis process as it has evolved. Individual swallows are analysed in a stepwise fashion for the morphology of the oesophagogastric junction (OGJ), the extent of OGJ relaxation, the propagation velocity of peristalsis, the vigour of the peristaltic contraction, and abnormalities of intrabolus pressure utilizing metrics that have now been customized to HROPT. These results are then synthesized into a comprehensive diagnosis that, although based on conventional manometry criteria, is also customized to HROPT measures. The resultant classification objectifies the identification of three unique subtypes of achalasia. Additionally, it provides enhanced detail in the description of distal oesophageal spasm, nutcracker oesophagus subtypes, and OGJ obstruction. It is our expectation that modification of this classification scheme will continue to occur and this should further clarify the utility of pressure topography plotting in assessing oesophageal motility disorders.
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影响因子：
12.6
作者：
Gruebel, Claudia;Hiscock, Richard;Hebbard, Geoff
通讯作者：
Hebbard, Geoff
DOI：
10.1152/ajpgi.00510.2005
发表时间：
2006-05-01
影响因子：
4.5
作者：
Ghosh, SK;Pandolfino, JE;Kahrilas, PJ
通讯作者：
Kahrilas, PJ
DOI：
10.1152/ajpgi.00252.2007
发表时间：
2007-10-01
影响因子：
4.5
作者：
Ghosh, Sudip K.;Pandolfino, John E.;Kahrilas, Peter J.
通讯作者：
Kahrilas, Peter J.
影响因子：
--
作者：
MITTAL, RK;REN, JL;SLUSS, J
通讯作者：
SLUSS, J
影响因子：
29.4
作者：
Bredenoord, AJ;Weusten, BLAM;Smout, AJPM
通讯作者：
Smout, AJPM