据报道,返流性食管炎患者的间歇性吞咽困难的发生率为8～45%。这种吞咽困难往往未被认识或误认为患者并发食管狭窄。“非阻塞性吞咽困难”(NOD)。是指吞咽固态或液态食物时有阻塞感,而内镜或放射学检查缺乏狭窄证据。NOD 的确切病机未明。本文旨在检测无狭窄的重度返流性食管炎患者NOD 的发生率。为了进一步了解NOD 的发病机理,作者还探讨了NOD与食管下段pH 和压力改变的关系,并特别注意食管内酸度对诱发吞咽困难的重要性。方法:63例重度、持续性食管功能异常病人(30例男性,平均59岁;33例女性,平均54岁。)病人每天诉有食管性症状,持续4月以上。对正规药物治疗反应差或无作用,均无食管恶性病变或Barrett 食管。全部病 It is reported that reflux esophagitis patients with intermittent dysphagia incidence of 8 to 45%. This difficulty swallowing is often not recognized or mistaken for patients with esophageal strictures. “Non-obstructive dysphagia” (NOD). Is a sense of obstruction when swallowing solid or liquid food, and lack of strict evidence of endoscopic or radiological examination. The exact pathogenesis of NOD is unknown. This article aims to measure the incidence of NOD in patients with stenotic severe reflux esophagitis. In order to further understand the pathogenesis of NOD, the authors also explored the relationship between NOD and changes in pH and pressure in the lower esophagus, paying particular attention to the importance of intra-esophageal acidity to induce dysphagia. Methods: Sixty-three patients with severe, persistent esophageal dysfunction (30 men, mean 59 years; 33 women, mean 54 years) complained of esophageal symptoms daily for more than 4 months. Poor response to formal drug therapy or no effect, no malignant esophageal lesions or Barrett’s esophagus. All disease