| Objective: Through correlation analysis,to explore the value of high-resolution esophageal manometry in the diagnosis of gastroesophageal motility diseases,especially gastroesophageal reflux disease,achalasia and hiatal hernia,so as to facilitate the clinical application in the future.Methods: A retrospective analysis of 160 patients who underwent high-resolution esophageal manometry in the Department of Gastroenterology,General Hospital of Ningxia Medical University from 2015 to 2019(including 62 cases of achalasia,36 cases of gastroesophageal reflux disease,And 18 cases of hiatal hernia),and related statistical analysis of relevant indicators.Results: 1.All the 160 patients successfully completed the examination with a success rate of 100%(160 / 160).The results of esophageal manometry showed that there were 62 cases of achalasia,13 cases of hiatal hernia,26 cases of general normal,28 cases of esophageal body movement dysfunction,16 cases of Les low pressure,14 cases of Les relaxation disorder and 1 case of ues relaxation disorder.2.The abnormal rate of HRM index: the patients with achalasia are mainly LESP,CFV,IBP and 4s IRPindex,the patients with gastroesophageal reflux disease are mainly LESP and DCI index,and the patients with hiatal hernia are mainly LESP and DCI index.3.In this study,the results of AC patients showed that LES relaxation was poor.Type I patients had an average of 4s IRP > 15 mmhg,100% swallowing without peristalsis,type II patients had an average of 4s IRP > 15 mmhg,no normal peristalsis,30 mm Hg whole esophagus pressurization standard swallowing > 20%,type III patients had an average of 4s IRP > 15 mmhg,no normal peristalsis,spasmodic swallowing > 20%.There were 62 cases of achalasia,9 cases of type I(14.52%),51 cases of type II(82.26),and 2 cases of type III(3.22%),Due to the small number of cases of type III,no relevant comparative analysis can be made,so the statistical comparison after removing type III shows that the incidence of dysphagia,nausea and vomiting,reflux,and chest pain in type II are higher than those of type I,but the differences are not statistical Difference(P>0.05).There was no statistical difference between UESP,LESL,LESP,DCI,CFV,DL,IBP,and 4s IRP of type I and type II(all P>0.05).The LESL was significantly higher in type ? patients than type ?,and the difference was statistically significant(P < 0.05).The positive rate of upper gastrointestinal angiography in patients with achalasia was 87.10%,the positive rate of high-resolution esophageal manometry was 100.00%.,and the difference was statistically significant(P<0.05).4.36 patients with gastroesophageal reflux disease were divided into two groups according to whether the mucosa was damaged under Gastroscope: reflux esophagitis(RE)and non erosive gastroesophageal reflux disease(NERD).There was no significant difference in the number,gender,age and BMI between the two groups(P>0.05).There was no significant difference in UESP,LESL,DCI,CFV,DL,and IBP between RE and NERD(all P>0.05).The LESP in RE was significantly higher than that in NERD,and the difference was statistically significant(P<0.05).There was no significant difference between RE and NERD in 24 h p H measurement(P>0.05),such as total time% for p H<4,total standing time% for p H<4,total lying time% for p H<4,number of reflux times of p H<4,times of reflux duration ? 5min,longest reflux duration and De Meester score.5.In 18 patients with hiatal hernia,the pressure measurement results of hiatal hernia suggest that LES is separated from the diaphragm,6(0.00%)were classified as type I,4(4%)as type II,and 8(66.67%)as type III in EGJ types.The positive rate of gastroscopy and high resolution esophageal manometry was 66.67% and 72.22%,respectively.There was no significant difference between the two methods(P>0.05).Conclusion: 1.High resolution esophageal manometry is of great value in the diagnosis of esophageal dyskinetic diseases,Patients with achalasia,gastroesophageal reflux disease,and hiatal hernia all have varying degrees of LES function and esophageal body motor dysfunction;2.High-resolution esophageal manometry for patients with gastroesophageal reflux disease can help diagnose the degree of esophageal dysmotility 3.High resolution esophageal manometry can improve the diagnosis rate of esophageal hiatal hernia. |
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