小结
定义
病史和体格检查
关键诊断因素
- 吞咽困难
其他诊断因素
- 摆出有助于吞咽的姿势
- 胸骨后压迫/疼痛
- 反流
- 逐渐消瘦
- 烧心
- 进食缓慢
- 平卧时咳嗽/窒息
- 反复的胸部感染
- 咽部异物感（癔球症）
- 呃逆
危险因素
- 疱疹病毒和麻疹病毒
- 自身免疫性疾病
- 人类白细胞抗原Ⅱ类抗原
- 血缘性双亲
- 三 A（Allgrove）综合征
诊断性检查
首要检查
- 上消化道内镜检查
- 钡餐
- 高分辨率食管测压
需考虑的检查
- 胸部 X 线检查
- 放射性核素食管排空试验
- 食管传输时间测定
- 胸部 CT
治疗流程
未确定治疗方案的患者
适宜手术的患者
不适宜手术的患者
撰稿人
作者
Jin-Yong Kang, MD, PhD, FRCP, FRCPEd, FRACP
Honorary Consultant Gastroenterologist
St George's Hospital
London
UK
利益声明
JYK declares that he has no competing interests.
Kalliopi Alexandropoulou, MD, FRCP
Consultant Gastroenterologist
Royal Surrey County Hospital
Guildford
Surrey
UK
利益声明
KA declares that he has no competing interests.
鸣谢
Dr Jin-Yong Kang would like to gratefully acknowledge Kalliopi Alexandropoulou, a previous contributor to this topic. KA declares that she has no competing interests.
同行评议者
Nigel Trudgill, MB ChB
Consultant Gastroenterologist
Sandwell General Hospital
West Bromwich
UK
利益声明
NT declares that he has no competing interests.
John de Caestecker, BChir
Consultant in General Medicine
Leicester General Hospital
Leicester
UK
利益声明
JdC declares that he has no competing interests.
David Hackam, MD, PhD
Assistant Professor of Surgery
Children's Hospital of Pittsburgh
Pittsburgh
PA
利益声明
DH declares that he has no competing interests.
George Y. Wu, MD, PhD
Professor of Medicine
University of Connecticut Health Center
Farmington
CT
利益声明
GYW is on the medical advisory boards of the following: Gilead Sciences, Bristol-Myers Squibb, AbbVie, and Intercept.
鉴别诊断
- 食管癌
- 反流性食管炎
- 结缔组织病（如系统性硬化）
更多 鉴别诊断指南
- 美国胃肠道内镜学会消化掉内镜操作知情同意指南
- 食管测压和食管反流监测指南
更多 指南
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