Application of 24 hour oesophageal pH and bilitec monitoring in the diagnosis and treatment of gastrointestinal reflux
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摘要:
目的：探讨酸、胆汁与反流症状、消化不良症状、消化道以外的症状间关系以及24 h食管pH和／或胆红素监测在新型术式客观评价中的作用。方法：应用24 h食管pH及胆红素监测方法对68例有典型反流症状者，50例有消化不良症状者，20例咽部不适及哮喘，32例食管贲门癌不同术式患者进行监测。结果： ①68例有典型反流症状者发生反流占95.5%，而在50例有消化不良症状如有反胃、上腹饱胀、嗳气等而无典型反流症状者中发生反流占72%。②典型酸反流症状者中混合反流占51.4%，即发生反流者中有一半为酸和胆汁反流同时存在。③24 h食管pH监测，结果提示保留贲门的食管癌根治间置结肠代食管术治疗的患者发生酸反流者明显少于经典式食管癌根治术治疗者（29.4% vs 66.7%，P < 0.05）。结论：24 h食管pH及胆红素监测为临床诊断胃食管反流或十二指肠胃食管反流的存在提供了客观依据，为食管癌根治新术式的评价提供客观依据。
Abstract:
Objective： To investigate the relationship between reflux of acid／bilirubin and reflux， dyspepsia and symptoms from non-gastrointestinal tract， and to study the role of 24 h esophageal pH and bilitec monitoring in evaluating the new method of esophageal operation. Methods: Using the method of 24 h esophageal pH and bilitec monitoring， the acid and bilirubin in esophagus from 68 patients with typical reflux， 50 patients with dyspepsia； 20 patients with symptoms from non-gastrointestinal tract， and 32 patients undergoing esophageal operation were measured. Results：Of 68 patients with typical reflux， 65 presented with reflux episodes， with an incidence of 95.6%. Of 50 patients with dyspepsia symptoms，the incidence of reflux episodes was 72%. In patients with typical reflux， 51.4% presented with mixture reflux of acid and duodenal liquid. The incidence of reflux incidence in patients with new method of esophageal operation（preserving cardia and utilizing colon instead of esophagus） was lower， compared with the routine method（29.4% vs 66.7%，P < 0.05）. Conclusion： 24 h esophageal pH and bilitec monitoring provide an objective and effective method not only to diagnosis gastroesophageal reflux and duodenal-gastroesophageal reflux but also to evaluate the curative effect of the new operation method.
