目的:食管功能检测是评价难治性GERD和食管动力紊乱的重要组成部分。这篇综述总结了目前可用于食管功能测试的技术,包括功能性管腔成像探头(FLIP),高分辨率食管测压(HRM),和多通道管腔内阻抗(MII)和pH监测。
方法:我们进行了MEDLINE,PubMed,和MAUDE数据库文献检索,使用以下关键词识别到2021年3月的相关临床研究:食管测压,HRM,食管阻抗,FLIP,MII,和食道pH检测。技术数据来自传统和网络出版物,专有出版物,以及与相关供应商的非正式沟通。报告起草完毕,reviewed,由美国胃肠内窥镜技术委员会编辑,并由美国胃肠内窥镜学会理事会批准。
结果:FLIP是一种高分辨率阻抗平面测量系统,用于食道中的压力和尺寸测量,幽门,还有肛门括约肌.FLIP为食管运动障碍的人力资源管理提供补充信息,尤其是贲门失弛缓症.芝加哥分类,基于人力资源管理数据,是一种广泛采用的用于诊断食管运动障碍的算法方案。MII检测腔内推注运动,结合pH测量或测压,提供有关难治性GERD患者的酸性和非酸性胃食管反流和推注转运的信息,以及抗反流手术的术前评估。
结论:食管功能测试技术(FLIP,HRM,和MII-pH)在评估食管运动障碍和难治性GERD中具有诊断和预后价值。较新的技术和分类系统使人们对这些疾病有了更多的了解。
OBJECTIVE: Esophageal function testing is an integral component of the evaluation of refractory GERD and esophageal motility disorders. This review summarizes the current technologies available for esophageal function testing, including the functional luminal imaging probe (FLIP), high-resolution esophageal manometry (HRM), and multichannel intraluminal impedance (MII) and pH monitoring.
METHODS: We performed a MEDLINE, PubMed, and MAUDE database literature search to identify pertinent clinical studies through March 2021 using the following key words: esophageal manometry, HRM, esophageal impedance, FLIP, MII, and esophageal pH testing. Technical data were gathered from traditional and web-based publications, proprietary publications, and informal communications with pertinent vendors. The report was drafted, reviewed, and edited by the American Society for Gastrointestinal Endoscopy Technology Committee and approved by the Governing Board of the American Society for Gastrointestinal Endoscopy.
RESULTS: FLIP is a high-resolution impedance planimetry system used for pressure and dimension measurement in the esophagus, pylorus, and anal sphincter. FLIP provides complementary information to HRM for esophageal motility disorders, especially achalasia. The Chicago classification, based on HRM data, is a widely adopted algorithmic scheme used to diagnose esophageal motility disorders. MII detects intraluminal bolus movement and, combined with pH measurement or manometry, provides information on acid and non-acid gastroesophageal reflux and bolus transit in patients with refractory GERD and for preoperative evaluation for anti-reflux procedures.
CONCLUSIONS: Esophageal function testing techniques (FLIP, HRM, and MII-pH) have diagnostic and prognostic value in the evaluation of esophageal motility disorders and refractory GERD. Newer technologies and classification systems have enabled an increased understanding of these diseases.