Oddi括约肌测压及内镜下十二指肠乳头切开术对Oddi括约肌运动功能障碍诊治的意义

Sphincter of Oddi Manometry and EPT in the Diagnosis and Treatment of Patients with Suspected Sphincter of Oddi Dysfunction

本文对60例胆囊切除术后复发腹痛患者进行0ddi括约肌测压研究,并探讨内镜下十二指肠乳头切开术(EPT)对Oddi括约肌基础压升高患者疗效。用低顺应性水灌注系统,三通道测压导管,观察Oddi括约肌基翻压、Oddi括约肌基础收缩幅度、频率和传播方式。对Oddi括约肌基础压>35mmHg者,随机分为两组,一组予以EPT治疗,另一组做为对照,并随访其疗效。结果发现:Oddi括约肌测压异常发生率为46.7％。Oddi括约肌基础压升高者,EPT治疗后,随访3～18月,有效率为91.7％,明显高于对照组(P<0.05)。结论:Oddi括约肌测压对Oddi括约肌运动功能障碍(SOD)的诊断具有较高价值。测压发现Oddi括约肌基础压升高患者EPT可获得满意的长期疗效。

Background/Aims: Endoscopic sphincter of Oddi manometry was carried out in 60 post-cholecystectomy patients with recurring abdominal pain to investigate the diagnostic value and to observe the outcome after EPT in patients with elevated basal sphincter pressure. Methods: A triple-lumen low compliance system was used to record the sphincter of Oddi basal pressure, phasic contraction frequency, amplitude and direction of wave propagation. Patients with basal sphincter pressure >35mmHg were randomized divided into two groups. One group was treated with EPT, the other group was treated with sham EPT. All of the patients were followed up. Results: The total prevalence of manometric abnormalities was 46.7%. Three to 18 months followed up after EPT, 91.7% patients with elevated basal sphinctr pressure were free from symptoms, which were higher than those of control (P<0.05). Conclusions: Sphincter of Oddi manometry had great value in the diagnosis of spincter of Oddi, dysfunction, and the long-term outcome after EPT in patients with elevated basal sphincter pressure was sutisfactory.