Đánh giá rối loạn nhu động thực quản trên bệnh nhân có triệu chứng trào ngược kháng trị=Evaluation of esophageal motility disorders in patients with refractory reflux-like symptoms

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Tác giả: Hoàng Long Đoàn, Minh Thùy Lê, Thanh Quỳnh Ngân Lê

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Y học Việt Nam (Tổng hội Y học Việt Nam), 2024

Mô tả vật lý: tr.209-215

Bộ sưu tập: Metadata

ID: 243879

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The study aimed to describe the prevalence of esophageal motility disorders among individuals with refractory reflux-like symptoms and compare clinical symptoms and some parameters in high-resolution manometry (HRM) between patients with and without erosive esophagitis in endoscopic findings. Methods: A descriptive study was conducted among 121 patients with refractory reflux-like symptoms performed HRM from January 2023 to January 2024 at Tam Anh General Hospital, Ho Chi Minh City, Vietnam. Results: The mean of age was 46 ± 13 and 52,1% were males. According to the Chicago classification version 4.0, the proportions of esophageal motility groups were: 38% normal, 7,4% achalasia, 23,1% esophagogastric junction outflow obstruction, 1,7% absent contractility, 24% ineffective esophageal motility and 5,8% distal esophageal spasm. The mean resting lower esophageal sphincter (LES) and 4-second integrated resting pressure (4s IRP) were significantly lower in the group with erosive esophagitis compared to the group without erosive esophagitis in endoscopic findings (23,3 ± 14,9 versus 33,4 ± 32,7 and 11,2 ± 11,1 versus 19,3 ± 25,9, respectively, p <
0,05). After adjusting for some parameters, 4s IRP <
5mmHg was positively associated with erosive esophagitis in endoscopic findings (OR 15,54
95% Confidence Interval: 1,21 – 199,16
p = 0,035). Conclusion: Ineffective esophageal motility was the most common motility disorder in patients with refractory reflux-like symptoms. 4s IRP <
5mmHg was positively associated with erosive esophagitis in endoscopic findings.Xác định tỉ lệ các nhóm rối loạn nhu động thực quản trên bệnh nhân có triệu chứng trào ngược kháng trị và so sánh một số đặc điểm giữa nhóm có và không có viêm thực quản trên nội soi. Phương pháp nghiên cứu: Nghiên cứu cắt ngang trên 121 bệnh nhân có triệu chứng trào ngược kháng trị được đo HRM từ tháng 01/2023 đến tháng 01/2024 tại phòng khám Tiêu hóa, Bệnh viện đa khoa Tâm Anh TP.HCM. Kết quả: Tuổi trung bình 46 ± 13 và 52,1% nam giới. Tỉ lệ nhóm nhu động theo Chicago 4.0: 38% bình thường, 7,4% co thắt tâm vị, 23,1% tắc nghẽn vùng nối, 1,7% mất nhu động hoàn toàn, 24% nhu động không hiệu quả (IEM), 5,8% co thắt đoạn xa. Áp lực nền cơ thắt thực quản dưới (LES) và áp lực tích hợp khi nghỉ trong 4 giây (IRP 4s) thấp hơn ở nhóm có so với nhóm không có viêm thực quản trên nội soi (lần lượt là 23,3 ± 14,9 so với 33,4 ± 32,7 và 11,2 ± 11,1 so với 19,3 ± 25,9, p <
0,05). Sau khi hiệu chỉnh cho một số đặc điểm lâm sàng, IRP 4s <
5mmHg có liên quan đến viêm thực quản (OR = 15,54
khoảng tin cậy 95% là 1,21 – 199,16
p = 0,035). Kết luận: IEM là rối loạn nhu động thường gặp nhất trên bệnh nhân có triệu chứng trào ngược kháng trị. IRP 4s <
5mmHg có liên quan đến viêm thực quản trên nội soi.

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