Analysis Of Esophageal Dynamics Characteristics And Etiology In Patients With Non Obstructive Dysphagia

Objective:By analyzing the results of high-resolution esophageal pressure measurement(HRM)in patients with non-obstructive dysphagia(NOD),the characteristics of esophageal dynamics and common causes of NOD patients are discussed to improve the understanding of NOD and provide early clinical diagnosis and treatment guide.Methods:The subjects of this study were selected from the Department of Gastroenterology of the first affiliated Hospital of Shihezi University Medical College from September 2018 to September 2019,whose main complaint was dysphagia.diagnosed as NOD after medical history inquiry and electronic gastroscopy,a total of 64 patients who met the inclusion criteria and were screened by the exclusion criteria were included in this study.The 36-channel solid-state high-resolution esophageal manometry system of the United States Sierra Scientific Instruments was used to collect data,according to the Chicago Classification3.0 diagnostic standard,through Mano View gastrointestinal motility analysis software,analyzing upper esophageal sphincter pressure(UESP),UES residual pressure,lower esophageal sphincter length(LESL),lower esophageal sphincter pressure(LESP),distal contraction integral(DCI),distal contraction delay time(DL),and possible etiological components in NOD patients,and compare the differences of HRM related results between NOD patients of different etiological groups.Results:1.A total of 64 NOD patients(27 males and 37 females)were included in this study,ranging in age from 29 to 64 years old,with an average age of(50.1±8.7)years old and a height of 165.1±8.3cm.There was no statistically significant difference in gender,age and height between each group(P > 0.05).2.Esophageal pressure measurement results of 64 NOD patients showed that nonspecific esophageal dynamic disorder(NEMD)was the most common type of esophageal dynamic disorder(39 cases,60.9%),followed by esophagogastric junction(EGJ)outflow obstruction(9 cases,14.1%)and achalasia(AC)(9cases,14.1%).Thirteen patients(20.3%)showed no abnormalities in esophageal manometry.3.The main manifestation of NEMD in 39 patients was distal esophageal spasm(18 cases,46.2%),peristalsis decreased(17 cases,43.6%)and no contraction(4 cases,10.2%).Among patients with weakened peristalsis,there were 8 cases(47.1%)with large peristalsis and 9 cases(52.9%)with small peristalsis.4.The differences between UESP,UES residual pressure,LESP,DCI,DL in the four groups of NOD patients were statistically significant(P <0.05),the difference between LESL is not statistically significant.Conclusion:1.NEMD was the most common disease in NOD patients,followed by EGJ outflow obstruction;Some NOD patients may show normal esophageal manometry.2.Esophageal motility disorder was the main dynamic characteristic of most NOD patients.