Zusammenfassung
Die intraluminale Manometrie wird zunehmend für die Diagnose ösophagealer Motilitätsstörungen eingesetzt. Die klinische Validität der Methode hängt jedoch entscheidend von einer exakten Standardisierung der Methodik, des Untersuchungsablaufes und der Kenntnis der Einflußgrößen auf das Meßergebnis ab. Im ersten Teil dieser Studie wurde der Einfluß verschiedener methodischer Faktoren auf das Ergebnis der Ösophagusdruckmessung in Modellversuchen, bei 44 gesunden Probanden und bei 74 Patienten mit axialer Hiatushernie mit einem elektromagnetischen Mikrotransducer untersucht. Signifikante Unterschiede der Meßwerte fanden sich in Abhängigkeit von der Sensorposition im oberen Ösophagussphinkter (p<0,001), von der Körperposition (Sitzen/Liegen) (p<0,005) und von der Art der Schluckakteinleitung (Trockenschlucken/Bolusgabe) (p<0,005). Keinen signifikanten Einfluß auf das Ergebnis der Druckmessung hatten dagegen unterschiedliche Durchzugsgeschwindigkeiten der Meßsonde und die Dauer der Untersuchung. Eine mechanische Stimulation des unteren Ösophagussphinkters durch den Meßvorgang war nicht nachweisbar.
Summary
Intraluminal manometry is increasingly used for the diagnosis of esophageal motor abnormalities. Clinical validity of this method depends on the exact standardization of methods, the performance of the study and on the knowledge of the factors influencing pressure measurement. In the first part of this study the significance of various methodical factors for esophageal pressure measurement accuracy was analysed in bench studies, in 44 healthy subjects and in 74 patients with hiatus hernia using an electromagnetic microtransducer. Significant differences of pressure values were observed depending on 1. sensor position in the upper esophageal sphincter (UES) (p<0.001), 2. body position (sitting vs. supine) (p<0.005) and 3. the mode of eliciting peristaltic pressure waves (dry vs. wet swallow) (p<0.005). No significant effect on pressure measurement results could be confirmed for the velocity of transducer pull-through and duration of the manometric examination. No mechanical irritation of the lower esophageal sphincter due to movements of the measuring probe was observed.
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To Prof. Dr. H.P. Wolff on the occasion of his 65th birthday
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Weihrauch, T.R., Brummer, A., Biewener, H. et al. Assessment of various factors influencing esophageal pressure measurement. Klin Wochenschr 58, 279–285 (1980). https://doi.org/10.1007/BF01476569
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DOI: https://doi.org/10.1007/BF01476569