胃食管反流病诊断技术评价及食管多通道腔内阻抗技术应用.pptVIP

胃食管反流病诊断技术评价及食管多通道腔内阻抗技术应用 阻抗技术应用 联合阻抗-pH监测反流 通过阻抗检测反流 通过pH区分酸碱度 联合阻抗-压力监测动力 通过阻抗检测食团运动方向 通过压力了解食管收缩状态 通过压力了解食管下括约肌的功能和解剖 胃食管反流病诊断技术评价及食管多通道腔内阻抗技术应用 单纯测压技术 (N=350) IEM 20% DES 9% normal 37% poor relaxing LES 9% hypertensive LES 7% hypotensive LES 1% achalasia 7% scleroderma 1% nutcracker 9% 29 % 的病人用单纯测压不能正确评估食团传输。 Combined Multichannel Intraluminal Impedance and Manometry Clarifies Esophageal Function Abnormalities: Study of 350 Patients; R. Tutuian D. Castell; American Journal of Gastroenterology; May 2004; 1011-1019 胃食管反流病诊断技术评价及食管多通道腔内阻抗技术应用 高清晰测压系统联合阻抗可见食团清除全过程 胃食管反流病诊断技术评价及食管多通道腔内阻抗技术应用 HRiM 联合两种监测 Probe Specifications Channels: 32 Pressure / 6 impedance Diameter: 12 French / 4 mm 阻抗电极评估食团传输 压力电极评估收缩性 胃食管反流病诊断技术评价及食管多通道腔内阻抗技术应用 食管体食团传输 食管体压力 LES压力 吞咽时的波形和颜色图 胃食管反流病诊断技术评价及食管多通道腔内阻抗技术应用 正常吞咽 胃食管反流病诊断技术评价及食管多通道腔内阻抗技术应用 食管运动不协调 胃食管反流病诊断技术评价及食管多通道腔内阻抗技术应用 吞咽后反流 胃食管反流病诊断技术评价及食管多通道腔内阻抗技术应用 贲门失迟缓 胃食管反流病诊断技术评价及食管多通道腔内阻抗技术应用 食管远端痉挛 The fewer the ions in the esophagus, the higher the impedance value. When a bolus passes over a set of impedance rings, the ionic content increases and lowers the impedance value. * Refluxate contains the highest number of ions and therefore will cause the impedance to drop lower. Inversely, air has very few ions and will cause the impedance waveform to rise. * * On this slides we can see the 2 possible bolus movements as detected by MII. The top of both graphs represents the more proximal electrodes. The bottom of both graphs represent the more distal electrodes. On the left side you can see, that progression from proximal to distal is indicative of antegrade bolus movement, for example swallowing. ? On the right side you can see, that progression from distal to proximal is indicative of retrograde bolus, for example reflux. * * 胃食管反流病诊断技术评价及食管多通道腔内阻抗技术应用 食管胆汁反流测定 Bilitec 2000胆汁反流监测仪是光纤分光光度计。可通过检测胆红素来反映胆汁反流存在与否及其程度。 随着食管多通道腔内阻抗监测的出现．该检查已逐渐被淘汰。 胃食管反流病诊断技术评价及食管多通道腔内阻抗技术应用 无线pH监测(Bravo技术) 新研制的Bravo无线便携式食管pH监测方法是将一个6 rnmx6 mmx26