食管闭锁修复后儿童食管运动模式及丸输送

C. Bingham, E. White, M. Papadopoulos, M. Mutalib
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引用次数: 0

摘要

食管闭锁(EA)修复术后常见食管运动障碍。食道测压(HRM)是研究运动性的金标准。我们的目的是描述EA修复儿童的食道运动障碍和液体和固体的推注传输。EA修复儿童HRM的回顾性分析。对每个孩子5只液体和5只固体燕子的标准测压和蠕动模式进行了评估。阻抗描记用于评估推注传输。对9名患者(44%为女性)进行了90次测量。平均年龄10.5(±4.6)岁。所有儿童都有吞咽困难,吻合口狭窄被排除在外。没有一个孩子的蠕动完整,44.4%的液体吞咽失败,33.3%的碎片和22.2%的无效。44.4%的固体燕子失败,44.4%的碎片和11.1%的无效。33.3%的患者在整个食道内有不完全的团传输,44.4%的患者在食道上部,11%的患者在食管下部。液体的平均蠕动中断时间为7 cm(±2.1),固体为5.9 cm(±3.2)P。025。食管动力受损是电针后的普遍修复。蠕动失败和无效主要表现为团块运输不完全,液体和固体吞咽后蠕动中断。HRM可以提供EA修复后的临床指导、诊断和预后信息。
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Patterns of Esophageal Motility and Bolus Transit in Children With Repaired Esophageal Atresia
Esophageal dysmotility is common after esophageal atresia (EA) repair. Esophageal manometry (HRM) is the gold standard to investigate motility. We aim to characterize esophageal dysmotility and bolus transit for liquid and solids in children with repaired EA. Retrospective analysis of HRM from children with repaired EA. Five liquid and 5 solid swallows per child were assessed for the standard manometric measurement and peristalsis pattern. Impedance tracings were used to assess bolus transit. Ninety measurements were assessed from 9 patients, 44% Females. Mean age was 10.5 (±4.6) years. All children had dysphagia and anastomotic strictures were excluded. None of the children had intact peristalsis, 44.4% of the liquid swallows were failed, 33.3% fragmented and 22.2% ineffective. 44.4% of the solid swallows were failed, 44.4% fragmented and 11.1% ineffective. 33.3% had incomplete bolus transit in the whole esophagus, 44.4% in the upper and 11% in the lower esophagus. Mean peristalsis break for liquid was 7 cm (±2.1) and for solid was 5.9 cm (±3.2) P .025. Impaired esophageal motility is universal post EA repair. Failed and ineffective peristalsis predominate with incomplete bolus transit and large peristalsis breaks after liquid and solid swallows. HRM can provide clinical guidance, diagnostic and prognostic information post EA repair.
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