Five year prospective study of the incidence, clinical features, and diagnosis of achalasia in Edinburgh.
Five year prospective study of the incidence, clinical features, and diagnosis of achalasia in Edinburgh.
复制标题
对爱丁堡贲门失弛缓症的发病率、临床特征和诊断的五年前瞻性研究。
作者：
P. Howard;L. Maher;A. Pryde;E. Cameron;R. Heading
随着越来越多的可用性测压，贲门失弛缓症患者往往是指在早期阶段时，他们缺乏典型的特点，建立疾病。我们进行了一项为期五年的前瞻性研究，研究了未治疗的贲门失弛缓症的表现特征。20名男性和18名女性在整个成年期出现，诊断时的平均年龄为44岁（范围为17至76岁）。主要症状为吞咽困难：固体（100%）和液体（97%），胸痛（74%）和体重减轻（60%）。15例患者的内镜检查结果正常，33例钡剂检查中仅21例提示贲门失弛缓症。14人接受了胃食管反流治疗，但没有人被误诊为心脏病或精神病。洛锡安地区贲门失弛缓症的年发病率为0.8/100，000人口。持续性吞咽困难是贲门失弛缓症的主要症状，在整个成年生活中出现。然而，新近发生的贲门失弛缓症往往被误诊为胃食管反流病。由于内窥镜检查通常是正常的，并且通常不能通过放射学进行诊断，如果要在早期阶段识别和治疗病情，则需要进行测压检查。
With the increasing availability of manometry, patients with achalasia are often referred at an early stage when they lack the classic features of established disease. A prospective five year study of the presenting features of untreated achalasia referred to our department was undertaken. Twenty men and 18 women presented throughout adult life, with a mean age at the time of diagnosis of 44 years (range 17 to 76 years). The presenting symptoms were dysphagia: for solids (100%) and for liquids (97%), chest pain (74%), and weight loss (60%). Endoscopy was reported as normal in 15 patients and achalasia was suggested in only 21 of 33 barium examinations. Fourteen had been treated for gastrooesophageal reflux but none had been misdiagnosed as having cardiac or psychiatric disease. The annual incidence of achalasia in the Lothian region is 0.8/100,000 of population. Persistent dysphagia is the cardinal symptom of achalasia which presents throughout adult life. Nevertheless, recent onset achalasia is often misdiagnosed as gastrooesophageal reflux disease. Because endoscopy is frequently normal and the diagnosis is often not made by radiology, manometric investigation is necessary if the condition is to be recognised and treated at an early stage.