关于诊断胃食道逆流病的拉丁美洲共识
Jorge A Olmos1, John E Pandolfino2, María M Piskorz1
1Neurogastroenterology Sector, Hospital de Clinicas Jose de San Martin, Universidad de Buenos Aires, Buenos Aires, Argentina.
Neurogastroenterology and motility
|January 16, 2024
概括
诊断胃食道逆流性疾病 (GERD) 是复杂的. 专家建议在内镜和异常pH值监测上进行侵蚀性食道炎,作为GERD的关键诊断方法.
科学领域:
- 胃肠病学 胃肠病学
- 消化系统健康 消化系统健康
- 医学诊断 医学诊断 医学诊断
背景情况:
- 胃食道逆流性疾病 (GERD) 诊断面临各种症状和复杂的原因带来的挑战.
- 通过pH测量的食道酸暴露时间 (AET) 是GERD诊断的既定黄金标准.
- 存在众多的诊断工具,需要专家就其实用性达成共识.
研究的目的:
- 根据当前的证据,评估各种GERD诊断工具的个别优点.
- 通过专家讨论和投票建立对GERD诊断的共识建议.
主要方法:
- 15名国际专家形成了共识.
- 使用系统的文献搜索和GRADE方法来评估证据的质量和强度.
- 制定了关于GERD工具的诊断实用性的建议,使用AET作为参考标准.
主要成果:
- 质子抑制剂 (PPI) 试验适用于没有警报症状的胃灼热,但不适用于反,胸痛或食道外症状.
- 严重的侵蚀性食道炎和PPI外的异常反流监测强烈表明GERD.
- 消化管,活检,喉腔镜和喉pH值监测不建议用于GERD诊断. 在正常内镜检查的PPI耐火病例中,反流监测 (pH或pH阻抗) 是至关重要的. pH阻抗可以检测胃前吐;阻抗测量可以诊断反.
结论:
- 侵蚀性食道炎的内镜检测和异常pH或pH阻抗监测是诊断GERD的最可靠方法.
- 额外的诊断工具可以在特定的临床场景中提供有价值的补充信息.
相关概念视频
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