高分辨率阻抗测压研究的阻抗数据解读--全球调查。

IF 3.3 3区 医学 Q2 CLINICAL NEUROLOGY Journal of Neurogastroenterology and Motility Pub Date : 2024-01-30 DOI:10.5056/jnm23057
Lev Dorfman, Sherief Mansi, Khalil El-Chammas, Chunyan Liu, Ajay Kaul
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引用次数: 0

摘要

背景/目的:食管测压是食管运动评估的黄金标准。带阻抗的高分辨率食管测压法(HRIM)可同时评估栓子通过情况和食管测压法。同时进行的阻抗和测压数据之间的不一致性造成了临床难题,目前尚未得到解决。我们旨在评估全球消化内科医生对 HRIM 数据的解释趋势:方法:我们采用匿名调查的方式对全球的胃肠病学家进行了一项横断面研究。结果:我们收到了 107 位消化科医生的回复:我们收到了来自 107 位消化内科医生(26 个国家)的回复。大多数是成人医疗人员(69 人,占 64.5%),大多数(77 人,占 72.0%)有 5 年以上的工作经验。83位(77.6%)参与者认为阻抗有帮助,但超过30%的参与者表示阻抗和测压数据不一致。在栓剂清除不完全和测压正常的情况下,41 人(38.7%)建议观察,41 人(38.7%)建议 24 小时 pH 阻抗,16 人(15.1%)建议使用促动力疗法。对于测压异常和完全栓剂清除的患者,60(57.1%)人建议观察,18(17.1%)人建议 24 小时 pH 阻抗,15(14.3%)人建议促动力治疗。不同大洲的医疗服务提供者在治疗阻抗和测压结果不一致的病例时存在明显差异(P < 0.001)。成人与儿科医疗人员之间以及具有不同工作经验的医疗人员之间的反应没有明显差异:结论:在解释 HRIM 数据方面尚未达成共识。对于测压数据和阻抗数据不一致的研究,医疗服务提供者的处理方法各不相同。在 HRIM 研究中,对阻抗数据解释指南的需求尚未得到满足。
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Interpretation of Impedance Data on High-resolution Impedance Manometry Studies-A Worldwide Survey.

Background/aims: Esophageal manometry is the gold standard for esophageal motility evaluation. High-resolution esophageal manometry with impedance (HRIM) allows concurrent assessment of bolus transit and manometry. Inconsistencies between concomitant impedance and manometry data pose a clinical dilemma and has not yet been addressed. We aim to assess interpretation trends of HRIM data among gastroenterologists worldwide.

Methods: A cross-sectional study using an anonymous survey was conducted among gastroenterologists worldwide. Statistical analysis was performed to compare responses between providers.

Results: We received responses from 107 gastroenterologists (26 countries). Most were adult providers (69, 64.5%), and most (77, 72.0%) had > 5 years of experience. Impedance was found to be helpful by 83 (77.6%) participants, but over 30% reported inconsistencies between impedance and manometry data. With incomplete bolus clearance and normal manometry 41 (38.7%) recommended observation, 41 (38.7%) recommended 24-hours pH-impedance, and 16 (15.1%) recommended prokinetics. With abnormal manometry and complete bolus clearance, 60 (57.1%) recommended observation while 18 (17.1%) recommended 24-hours pH impedance and 15 (14.3%) recommended prokinetics. A significant difference was found between providers from different continents in treating cases with discrepancy between impedance and manometry findings (P < 0.001). No significant differences were seen in responses between adult versus pediatric providers and between providers with different years of experience.

Conclusions: There is no consensus on interpreting HRIM data. Providers' approaches to studies with inconsistencies between manometry and impedance data vary. There is an unmet need for guidelines on interpreting impedance data in HRIM studies.

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来源期刊
Journal of Neurogastroenterology and Motility
Journal of Neurogastroenterology and Motility GASTROENTEROLOGY & HEPATOLOGY-CLINICAL NEUROLOGY
CiteScore
6.30
自引率
8.80%
发文量
96
期刊介绍: Journal of Neurogastroenterology and Motility (J Neurogastroenterol Motil) is a joint official journal of the Korean Society of Neurogastroenterology and Motility, the Thai Neurogastroenterology and Motility Society, the Japanese Society of Neurogastroenterology and Motility, the Indian Motility and Functional Disease Association, the Chinese Society of Gastrointestinal Motility, the South East Asia Gastro-Neuro Motility Association, the Taiwan Neurogastroenterology and Motility Society and the Asian Neurogastroenterology and Motility Association, launched in January 2010 after the title change from the Korean Journal of Neurogastroenterology and Motility, published from 1994 to 2009.
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