| Objective To evaluate esophageal manometry in patients with NOD by HRM and to analyze the esophageal dynamic characteristics of the patients with NOD,and to further analyze the role of the three kinds of bolus in detecting esophageal motility disorders.Methods Seventy patients with non-obstructive esophageal dysphagia and 10 healthy volunteers were enrolled in this study.Medical Measurement Systems' 22-channel water-perfusion pressure-measuring system was used to evaluate the effect of high-resolution esophageal pressure,the three methods in the detection of esophageal motility abnormalities were analyzed and compared.According to the Chicago classification V3.0 specification to analyze the test results.Results1.Among the 70 patients with NOD,there were 47 cases of esophageal motility abnormalities according to the Chicago classification V3.0,of which 15 cases were inactive esophageal motility(21.43%),9 cases were nonspecific esophageal motility abnormalities(12.86%),7 cases were Achalasia(10.00%),Fragmented peristalsis in 6(8.57%),absent contractility in 4(5.71%),hypercontractile esophagus in 3(4.29%)and distal esophageal spasm in 3(4.29%);23 cases of Normal esophageal(32.86%).2.A total of 59 cases(84.29%)of esophageal motility abnormalities were detected by viscose swallowing method,the detection rate was significantly higherthan that of liquid swallowing method,and the difference was statistically significant(P = 0.018).A total of 61 cases(87.14%)of esophageal motility abnormalities were detected by solid swallowing method.The detection rate was significantly higher than that of liquid swallowing method(P = 0.005).However,viscous swallowing compared with solid swallowing,esophageal motility abnormality detection rate was not statistically significant.3.The UES length and LES length in esophageal motility abnormal group,esophageal motility normal group and healthy control group were not statistically significant.The resting pressure UES,LES resting pressure of esophageal motility abnormal group,normal esophageal motility group were higher than the healthy control group,but there were no statistical significance.4.The 4sIRP of esophageal motility group,esophageal motility normal group and healthy control group,were compared respectively with each other in liquid swallow method,viscose swallowing method and solid swallowing method,and there were no significant difference.In esophageal motility abnormalities group,the 4sIRP of three groups swallowing method were compared with each other,and there were no statistical significance;In esophageal motility normal group,in the three groups swallowing method,4sIRP were compared with each other,and there was no statistical significance;In healthy control group,the 4sIRP of three groups swallowing method were compared with each other,and there were no statistical significance.5.The DCI of esophageal motility abnormal group,esophageal motility normal group and healthy control group were significantly different from each other in liquid,viscose and solid swallowing method respectively.In the esophageal motility abnormal group,there was significant difference between liquid swallow method and the solid swallowing method for DCI;there was no significant difference between liquid swallow method and viscose swallowing method,viscose swallow method andsolid swallowing method for DCI.In the normal esophageal motility group,there was a significant difference between the liquid swallow method and solid swallowing method for DCI;there was no significant difference between liquid swallow method and viscose swallowing method,viscose swallow method and solid swallowing method for DCI.In the healthy control group,there was no statistical significance in all pairs of DCI measured by liquid,viscose and solid swallowing methods.6.The DL of esophageal motility abnormal group,esophageal motility normal group and healthy control group were compared with each other and the difference were statistically significant;Respectively in liquid swallow method,viscose swallowing method,the DL of three groups were compared with each other,and there was no statistical significance.In the esophageal motility abnormal group,DL,which was respectively obtained by liquid swallowing method,viscose swallowing method and solid swallowing method,were compared with each other,and there were statistically significant.In the completely normal esophageal motility group,the DL of liquid swallowing method was compared with the DL of solid swallowing method,and the difference was statistically significant;the DL of liquid swallowing method and viscose swallowing method was compared and the DL of viscose swallow method and solid swallowing method was compared,and there were no significant difference.In the healthy control group,DL,which was respectively obtained by liquid swallow method and the solid swallowing method,were compared with each other,and there was a significant difference;the DL of liquid swallowing method and viscose swallowing method were compared and the DL of viscose swallowing method and solid swallowing method were compared,and there were no significant difference.7.The Breaks of esophageal motility abnormal group,esophageal motility normal group and healthy control group were significantly different from each other inliquid,viscose and solid swallowing method respectively.In the esophageal motility abnormal group,the Breaks of the liquid swallowing method and the solid swallowing method,viscose swallowing method and the solid swallowing method were compared respectively,and the differences were statistically significant;the Breaks of liquid swallowing method and viscose swallowing method was compared,and there was no significant difference.In the normal esophageal motility group,the Breaks of liquid swallowing and viscose swallowing,liquid swallowing and solid swallowing,viscose swallowing and solid swallowing method were compared with each other,which were not statistically significant.In the healthy control group,the Breaks which were measured by liquid,viscose and solid swallowing method were compared with each other,and there were no significant.Conclusions1.NOD mainly included IEM,NEMD,achalasia,intermittent peristalsis,no contraction,excessive esophageal contraction and DES.2.In conventional liquid swallow esophageal manometry method based on the addition of viscose,solid swallowing,can help improve the detection rate of esophageal motility abnormalities,especially the solid swallowing method.3.When normal healthy people swallowed three kinds of bolus,the esophageal peristalsis contractions are basically the same,but patients with NOD require greater esophageal peristalsis,longer systolic time,and more complete esophageal peristaltic contractile waves as they swallow viscose and solids,especially swallowing solids. |
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