一种多学科的方法来识别和管理异型胃入口补丁
L Ayres1, S Perring2, S A R Nouraei3
1Department of Gastroenterology, University Hospitals of Dorset NHS Foundation Trust, Poole, UK.
Neurogastroenterology and motility
|March 15, 2024
概括
胃入口斑块是喉和吞问题的常见原因,可以有效地用阿贡血凝固 (APC) 治疗. 新的粘膜阻抗梯度 (MIG) 度量有助于预测这些喉食道症状的治疗成功.
科学领域:
- 胃肠病学 胃肠病学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 消化道诊断 消化道诊断
背景情况:
- 胃入口补丁经常被偶然发现,但可以表现为喉食道症状的可治疗原因.
- 尽管这些斑块可能导致喉延长和吞困难,但这些斑块往往被忽视.
研究的目的:
- 评估阿贡血凝固 (APC) 在治疗胃入口补丁中的疗效.
- 通过使用新型的粘膜阻抗梯度 (MIG) 评估治疗反应与反流和粘膜完整度的相关性.
主要方法:
- 对被诊断患有胃入口补丁并呈现喉/吞症状的患者的回顾性审查.
- 使用临床重要差异最小化方法对治疗反应的评估.
- 计算近端和远端夜间平均基线阻抗 (MNBI) 和导出粘膜阻抗梯度 (MIG).
主要成果:
- 在接受过鼻腔泛指镜检查的8.7%的患者中,发现了胃入口贴片.
- 阿贡血凝固 (APC) 在带贴片的患者中实现了71%的治疗反应率.
- 粘膜阻抗梯度 (MIG) 大于-25%准确预测了APC响应 (AUC=0.875,灵敏度=81%,特异性=100%).
结论:
- 胃入口补丁是常见的,未被认可的,并且是持续的喉食道症状的可治疗原因.
- 用APC进行贴片切除对于选定的患者是有效的,最佳选择可能会被MIG增强.
- 多学科合作对于有效的患者选择和管理至关重要.
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