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食道运动障碍:诊断和治疗策略
Yoshimasa Hoshikawa1, Katsuhiko Iwakiri1
1Department of Gastroenterology, Nippon Medical School Graduate School of Medicine, Tokyo, Japan.
Digestion
|August 27, 2023
概括
食道运动障碍 (EMD) 需要使用高分辨率计量仪 (HRM) 进行准确的诊断. 本综述涵盖了EMD诊断和治疗,强调在侵入性手术前进行谨慎评估.
科学领域:
- 胃肠病学 胃肠病学
- 食道生理学 食道生理学
- 诊断技术 诊断技术
背景情况:
- 食道机动性障碍 (EMD) 源于关节放松或静脉静止功能受损,导致食欲失调和胸痛.
- 高分辨率测量仪 (HRM) 对于诊断初级EMD至关重要.
- 在日本的全科医生中,对EMD和HRM的认识有限.
研究的目的:
- 审查目前对EMD的诊断和治疗策略.
- 突出人力资源管理在EMD诊断中的作用.
- 为了解决日本对EMD和HRM的有限认可.
主要方法:
- 对EMD的诊断方式的审查.
- 讨论阿喀拉西亚和相关疾病的治疗选择.
- 强调更新的诊断指南和进一步的测试.
主要成果:
- 人力资源管理是EMD的特定诊断工具.
- 内镜和吞可以显示特征性迹象,如"食道红"和"鸟".
- 在阿卡拉西亚之外的手指测量诊断可能缺乏临床相关性.
结论:
- 在侵袭性治疗之前,准确的EMD诊断是必不可少的,因为病理生理学不清楚.
- 更新的指导方针建议额外的机动 (例如,快速饮料挑战) 和功能性光线成像以进行精确的诊断.
- 治疗阿喀拉西亚的治疗方案包括肌肉切割,肺部扩张和肉毒素注射.
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