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内镜阻抗平面测与高分辨率测量 (HRM) 用于在抗反流手术中进行术前运动性评估
Theresa N Wang1, Jennifer Underhill2, Robert Tamer3
1Department of Surgery, Center for Minimally Invasive Surgery, The Ohio State University, Columbus, OH, USA. theresanwang@gmail.com.
Surgical endoscopy
|October 6, 2023
概括
内阻抗平面测量 (IP) 耐受性很好,用于评估GERD患者的食道运动性. 然而,其低的特异性和预测值引发了人们对其可靠性作为高分辨率计量 (HRM) 的独立替代品的担忧.
科学领域:
- 胃肠病学 胃肠病学
- 消化系统疾病 消化系统疾病
- 医疗器械 医疗器械
背景情况:
- 胃食道逆流性疾病 (GERD) 的术前评估需要对食道运动性的准确评估.
- 高分辨率力度计 (HRM) 是这个评估的黄金标准.
- 使用Endoflip 2.0的内阻抗平面测量 (IP) 正成为评估食道运动障碍的替代工具.
研究的目的:
- 通过IP和HRM评估的正常食道运动之间的相关性.
- 在接受GERD手术评估的患者中,与HRM相比,评估IP的诊断性能.
- 评估IP与HRM的耐受性和患者偏好.
主要方法:
- 一项前性队列研究招募了63名接受GERD手术评估的患者.
- 患者接受了HRM和IP测试,HRM的芝加哥3.0标准定义的正常运动率和IP的重复性前级收缩.
- 统计分析包括逻辑回归和t测试,显著程度为p < 0.05.
主要成果:
- 在完成两项测试的48名患者中,62.5%的IP显示正常运动,75%的HRM显示正常运动.
- 与HRM相比,IP显示出检测正常运动的灵敏度为65.8%,特异性为50%.
- IP比HRM耐受得更好,不适率更低,愿意重复测试的意愿更高.
结论:
- 虽然Endoflip 2.0 (IP) 耐受性很好,但其在评估食道运动性时的诊断性能对于GERD手术前评估是可疑的.
- IP的低特异性和负预测值,以及缺乏与HRM的统计学显著一致性,表明它可能不是HRM的可靠独立替代品.
- 需要进一步的研究来澄清IP在食道运动性评估中的作用.
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