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目的 评价 2 4小时监测食管 p H及胆汁变化对反流性食管病的临床意义。方法 应用便携式 p H监测仪及胆汁监测仪同步动态监测 4 5例患者的食管 2 4 h p H及胆汁变化情况。结果 (1) 4 5例受检者中 ,病理性胃食管酸反流 15例 (33.3% ) ,十二指肠 -胃 -食管胆汁反流 (DGER) 2 5例 (5 5 .5 % ) ,病理性胃食管酸反流 15例同时伴有 DGER。 (2 ) 2 7例 DGER者胆汁反流期间 p H均值 =5 .2 3± 0 .93,酸反流 (p H<4 )时间百分比 =7.87± 15 .80 % ,碱反流 (p H>7)时间百分比 =5 .6 7± 6 .89%。 (3) 2 4 h总胆汁反流时间百分比与总酸反流时间百分比呈明显的正相关 (r=0 .91,P<0 .0 0 1) ,而与总碱反流时间百分比之间未见明确的相关性 (P>0 .35 )。结论 十二指肠 -胃 -食管胆汁反流与胃食管酸反流呈正相关 ,而与碱反流无明显相关性。 2 4 h p H监测诊断胃食管反流病有一定局限性 ,应同步进行动态 p H和胆汁监测
Objective To evaluate the clinical significance of esophageal p H and bile monitoring on reflux esophageal disease in 24 hours. Methods The changes of esophageal 24 h p H and bile in 45 patients were monitored simultaneously by portable p H monitor and bile monitor. Results Among 45 subjects, 15 cases (33.3%) had pathological gastroesophageal reflux and 25 cases (55.5%) had duodeno-stomach-esophageal bile reflux (DGER) , Pathological gastroesophageal reflux in 15 cases accompanied by DGER. (2) Mean p H values during bile reflux were 57.3 ± 0.93, acid reflux (p H <4) time percentage was 7.87 ± 15.80%, basal reflux (p H > 7) Percentage of time = 5.66 ± 6.89%. (3) The percentage of total bile reflux time was positively correlated with the total acid reflux time (r = 0.91, P <0.01), and the percentage of total reflux time No clear correlation was found (P> 0 .35). Conclusions Duodenal-gastric-esophageal bile reflux is positively correlated with gastroesophageal reflux, but not with basal reflux. 24 h p H monitoring diagnosis of gastroesophageal reflux disease has some limitations, should be synchronized dynamic p H and bile monitoring