Oddi括约肌运动功能障碍的诊断和治疗

Diagnosis and treatment of Oddi sphincter dyskinesia

Oddi括约肌运动功能障碍(SOD)是临床较难诊断和治疗的疾病之一.SOD诊断方法较多,但尚缺乏敏感性及特异性的诊断方法.目前认为Oddi括约肌压力测定(SOM)是诊断Oddi括约肌运动功能障碍的"金标准",但因其数据结果的准确性及测压后并发症等影响,难以在临床广泛开展.极少数SOD患者可通过药物治疗缓解症状,更多的SOD患者依靠内镜下乳头括约肌切开术(EST)治疗,EST是SOD最常用且有效的治疗方法,尚有部分患者需通过经十二指肠Oddi括约肌切开成形术及胆肠吻合等外科手术方法才能达到治疗目的.

Oddi sphincter dyskinesia is a digestive disease which is difficult to diagnose in time and treat properly. Although some methods can be used to diagnose Oddi sphincter dyskinesia, no convenient method with a high sensitivity is available at present. Oddi sphincter manometry is considered a golden diagnostic standard for Oddi sphincter dyskinesia. However, it has not been widely used in clinical practice, because it is inaccurate and unfaithful and often leads to severe complications. Only few patients with Oddi sphincter dyskinesia could be treated with chemical drugs. At present, endoscopic sphincterotomy （EST） is the best choice of treatment for Oddi sphincter dyskinesia. This paper discusses the role of Oddi sphincter manometry and EST in treatment of Oddi sphincter dyskinesia. Some patients need to undergo transduodenal sphicteroplasty or anastomosis of bile duct with intestine.