消化管胃结口外流阻塞 (EGJOO):一个尺度现象或临床影响力的问题
1Mayo Clinic Arizona, 13400 E. Shea Blvd, Scottsdale, AZ, USA.
Current gastroenterology reports
|March 28, 2024
概括
消化管胃节外流阻塞 (EGJOO) 的诊断和治疗正在发展. 临床上相关的EGJOO可以使用定时食道图 (TBE) 或功能性流明成像探针 (FLIP) 识别.
科学领域:
- 胃肠病学 胃肠病学
- 食道运动障碍 食道运动障碍
- 诊断成像 诊断成像 诊断成像
背景情况:
- 消化管胃节外流阻塞 (EGJOO) 的特点是消化管胃节放松受损,并保持周围静止.
- EGJOO可能是人造的,可能是其他原因的次要原因,或者是主要的运动障碍.
研究的目的:
- 审查临床相关EGJOO的不断发展的诊断和治疗方法.
- 突出TBE和FLIP在识别需要治疗的EGJOO中的作用.
主要方法:
- 审查关于EGJOO诊断和管理的当前文献.
- 对TBE和FLIP等诊断工具的评估.
- 评估治疗方式,包括气动扩张,口腔内镜肌切除术 (POEM),肉毒剂和赫勒肌切除术.
主要成果:
- TBE和FLIP对于识别易受低食道 (LES) 治疗的EGJOO有价值.
- 气动扩张和POEM在已确认EGJOO的无控制试验中显示出有效性.
- 可以考虑使用博托克斯和赫勒肌切除术,但对于确诊的EGJOO的数据更有限;博托克斯提供了暂时的缓解.
- 诊断需要症状,排除次要原因,并通过TBE或FLIP确认.
结论:
- 临床相关的EGJOO需要一种系统的诊断方法,排除其他病因.
- 肺部扩张和POEM是确诊EGJOO的有效治疗方法.
- 需要进行更多的随机对照试验,以确定EGJOO的最佳管理策略.
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