Intermittent spatial separation of diaphragm and lower esophageal sphincter favors acidic and weakly acidic reflux
Intermittent spatial separation of diaphragm and lower esophageal sphincter favors acidic and weakly acidic reflux
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DOI：
10.1053/j.gastro.2005.10.053
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发表时间：
2006-02-01
期刊：
影响因子：
29.4
通讯作者：
Smout, AJPM
中科院分区：
文献类型：
--
作者：
Bredenoord, AJ;Weusten, BLAM;Smout, AJPM
背景与目的：在小的食管裂孔疝中，疝的大小是可变的。通过高分辨率测压可以观察到间歇性完全降低，作为从双峰（疝）到单峰（降低）高压区的过渡。本研究的目的是调查间歇性分离的隔膜和食管下括约肌（LES）是否有利于胃食管反流的发生。方法：在16例小食管裂孔疝（3 cm）患者中，进行了长时间高分辨率测压。酸性和弱酸性反流事件检测pH阻抗监测。结果如下：单峰曲线（疝缩小）持续814分钟（总时间的56.5%），双峰曲线（疝未缩小）持续626分钟（总时间的43.5%）。在所有患者中，观察到两种压力曲线。2个曲线之间的转换速率为7.5 +/- 0.9/小时。与疝减少状态相比，LES和膈肌分离时发生更多的反流（分别为23.1 ± 5.1 vs 12.2 ± 2.4次/小时; P
Background & Aims: In small hiatal hernias, the size of the hernia is variable. Intermittent complete reduction can be observed with high-resolution manometry as a transition from a double-peak (hernia) to a single-peak (reduced) high-pressure zone. The aim of this study was to investigate whether intermittent separation of the diaphragm and lower esophageal sphincter (LES) favors the occurrence of gastroesophageal reflux. Methods: In :16 patients with a small hiatal hernia (3 cm), prolonged high-resolution manometry was performed. Acid and weakly acidic reflux episodes were detected with pH-impedance monitoring. Results: The single pressure peak profile (reduced hernia) was present for 814 minutes (56.5% of total time), and the double peak profile (unreduced hernia) was present for 626 minutes (43.5% of total time). In all patients, both pressure profiles were observed. The transition rate between the 2 profiles was 7.5 +/- 0.9 per hour. More reflux occurred when the LES and diaphragm were separated versus the reduced hernia state (23.1 +/- 5.1 vs 12.2 +/- 2.4 episodes per hour, respectively; P