食管ph（pH是解决溶液的酸度或碱度的量度）监测是一种测量从胃中酸反流（反流或反冲洗）的过程食管发生在胃食管反流病(格德）。
When is esophageal pH monitoring used?
如何进行食管pH监测？
- 食管pH监测是通过经过薄的plastic导管的第十六个在ch在diameter through one鼻孔，沿喉咙的后部，进入食道病人swallows. The tip of the catheter contains a sensor that senses acid. The sensor is positioned in the esophagus so that it is just above the lower esophageal sphincter, a specialized area of esophageal肌肉that lies at the junction of the esophagus and stomach and prevents acid from refluxing back up into the esophagus. In this position the sensor records each reflux of acid. The catheter protruding from the鼻子is connected to a recorder that registers each reflux of acid.
- 患者被带到了导管和录音机的回家，第二天返回以将其删除。在导管到位的24小时内，患者会走他的or her usual activities, for example, eating, sleeping, and working. Meals, periods ofsleep， 和symptoms are recorded by the patient in a diary and/or by pushing buttons on the recorder. After the catheter is removed, the recorder is attached to a computer so that the数据it has gathered can be downloaded into the computer where it is analyzed and put into graphic form. The procedure can be modified by placing the sensor in the upper esophagus or pharynx to determine if refluxed acid is reaching the pharynx.
- 最近开发的用于监测食道pH的设备使用胶囊也称为Bravo胶囊。胶囊含有酸感应探测, a battery, and a transmitter. The probe monitors the acid in the esophagus and transmits the information to a recorder that is worn by the patient on a belt. The capsule is introduced into the esophagus on a catheter through the nose or嘴and is attached to the lining of the esophagus with a clip. The catheter then is detached from the capsule and removed. Thus, there is no catheter protruding from the nose. The capsule transmits for two days or three days, and then the battery dies. Five to seven days later, the capsule falls off the esophageal lining and is passed in the凳子as the capsule is not reusable.
- 胶囊设备的优势与连接探针连接到录音机的导管的缺失有关。没有导管在喉咙后部没有更大的舒适感，患者更有可能去上班，做更多的正常活动，而不会自觉地对其他人的出现感到自觉。胶囊的缺点是它不能在咽部中使用（在那里不舒服），到目前为止，它尚未在胃中使用。
如何使用食管pH监测？
- 几乎每个人都有一些酸性回流，但是回流的量很小，很少是原因炎食管（食道炎）。作为数量酸回流高于该增长普通范围，也是可能性of developing esophagitis and its symptoms. In patients with symptoms that suggest acid reflux, a诊断可以通过在食道中显示酸性pH值的时间比正常时间大于时间来进行反流。
- A common alternative method to diagnose reflux is to treat patients with medications that reduce reflux. If the patient's symptoms stop, then the symptoms are likely to be due to acid reflux. Another way of diagnosing acid reflux as the cause of symptoms is to demonstrate that episodes of acid reflux recorded by esophageal pH monitoring occur at exactly the same time as esophageal疼痛。
- 食管pH监测也可用于确定为什么反流治疗不起作用。例如，接受酸性反流治疗的患者可能会继续出现症状。如果是这样，则必须问一个问题，即为什么症状继续存在。是因为药物是否足够，或者是因为症状不是由于反流引起的，因此不会对反流的治疗做出反应？如果pH监测研究在患者服用他或她的药物反射时进行abnormal流动量不足，需要改变治疗。如果胃酸反流的量在正常范围, then it is likely that the symptoms are not being caused by acid reflux, and other potential problems need to be considered as the cause of the symptoms.
SLIDESHOW
消化障碍：常见的误解请参阅幻灯片食管pH监测的局限性是什么？
- 异常的胃酸反流的证明并不意味着症状是由反流引起的。只有用治疗反流的药物以及症状明显减轻的药物治疗才能证明反流作为症状的原因。然而，重要的是要记住治疗与安慰剂反应。例如，有10％至20％的没有胃酸反流的患者报告了anti-回流药物s. Therefore, even a good response to treatment does not definitely prove that reflux is the cause of symptoms.
- 一些发作的最有力的证据chest通过证明疼痛发作与胃酸反流的发作相吻合，可以通过胃酸反流引起疼痛。但是，如果反流的频繁发作，则可能无法分开一个trueassociation在a之间symptom由于反流的发作频率很高，因此偶然关联的回流。
- 相反，如果很少发生症状，例如每隔几天一次，则不太可能在常规的24小时监测期间发生症状，因此，不可能发生相关性。解决后一个问题的一种尝试是将监视扩展到几天，但是这种扩展的监控很少进行。
Are there other ways in which pH monitoring can be used?
- If the pH sensor is left in the stomach instead of the esophagus, it is possible to determine the effectiveness of medications that shut off the production of acid in the stomach. This information may be useful in determining the proper doses of medications among patients with acid-related conditions of the stomach andduodenum（例如，消化性溃疡）。也可以将带有两个酸传感器的导管放置，以便一个传感器在胃中，另一个传感器在下方食道。使用此导管，可以评估这两种酸性食管反流以及酸抑制药物的有效性。
- 可以将pH传感器放在上方的食道或咽部旁边食管括约肌上方，患有无法解释的症状的患者咽喉痛、声音嘶哑或咳嗽。在这些患者中,the demonstration of acid reflux into the upper esophagus or pharynx suggests that acid reflux may be the cause of the symptoms. Recent studies however have shown that the association of these symptoms with acidic reflux may not be reliable.
What are the side effects of esophageal pH monitoring?
- There are very few side effects of esophageal pH monitoring. Although there may be mild discomfort in the back of the throat while the catheter is in place, particularly during swallows, the majority of patients have no difficulty eating, sleeping, or going about their daily activities.
- 但是，大多数患者都不愿意上班，因为他们对从鼻子伸出的导管感到自觉。胶囊设备在吞咽时可能会引起不适。胸部感到不适，可能是由于foodor the wave of esophageal收缩通过时拉动胶囊。
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参考
Madan, Kaushal, et. all. "Impact of 24-h Esophageal pH Monitoring on the Diagnosis of Gastroesophageal Reflux Disease: Defining the Gold Standard." Medscape.com.