远端食道:一个更新的审查
Eli A Zaher1, Parth Patel1, George Atia2
1Internal Medicine, Ascension Health - Saint Joseph Hospital, Chicago, USA.
Cureus
|August 8, 2023
概括
远端食道导致吞困难和胸痛,原因是食道过早收缩. 诊断依赖于高分辨率测量仪,但有效的治疗方法仍然有限,需要进一步研究.
科学领域:
- 胃肠病学 胃肠病学
- 食道运动障碍 食道运动障碍
背景情况:
- 远端食道 (DES) 是一种运动障碍,其特征是远端食道过早收缩.
- 症状包括非阻塞性消化不良和非心脏性胸痛.
- 目前的诊断标准和治疗方法需要改进.
研究的目的:
- 审查诊断标准和远端食道的管理.
- 为了突出诊断模式的最新进展,如高分辨率测量仪和功能光成像探针.
- 讨论当前的治疗局限性和未来的研究方向.
主要方法:
- 关于诊断和管理远端食道的当前文献的审查.
- 对芝加哥分类对食道力度的更新进行分析.
- 评估新兴的诊断工具和治疗策略.
主要成果:
- 诊断DES需要症状和预先收缩 (>20%) 的尺度证据,以及正常的食道下关节放松.
- 高分辨率测量仪,特别是更新的芝加哥分类,提高了诊断的准确性.
- 功能光成像探针提供了食道运动性的全面评估.
- 目前,药物治疗对DES来说还不够.
- 内镜性肌肉切除显示出非食性食道机动性障碍的潜力.
结论:
- 精确的DES诊断通过高分辨率测量和更新的分类来提高.
- 仍然缺乏对DES的有效和长期的管理策略.
- 对病理生理学和治疗的进一步研究对于改善患者的治疗结果至关重要.
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