袖套式Oddi括约肌压力测定法在Oddi括约肌功能紊乱中的应用

Application of Sleeve type Oddi sphincter pressure measurement in the diagnosis of Oddi sphincter of Oddi dysfunction

目的 探讨袖套式Oddi括约肌压力测定法（Sleeve type Oddi sphincter pressure measurement,SOM）在Oddi括约肌功能紊乱诊疗中的作用。方法 纳入拟诊为Oddi括约肌功能紊乱患者共26例及对照组患者2例,进行SOM,测定项目包括SO基础压、收缩压、收缩振幅及收缩频率。术后监测各时间点患者的疼痛评分、血清淀粉酶的变化,及术后24 h检查上腹部CT。结果 全部患者均耐受操作,平均操作时间（16.5±0.4）min,与传统的压力检测结果比较,所有患者两次检测的SO基础压、收缩压、收缩振幅及收缩频率差异均无统计学意义（P〉0.05）,其中基础压基本一致。术后1例患者出现轻型胰腺炎,其余27例患者术后48 h内疼痛评分为0~2分,血清淀粉酶及上腹部CT均正常。全部患者未出现其他并发症发生。结论 新型SOM法操作简单,结果可靠,监测时间可控,术后并发症少,并可进行胰管括约肌检测,适合在临床开展。此方法可取代传统灌注式多极压力测定法,用于Oddi括约肌功能紊乱的诊断。

Objective To discuss the role of Sleeve type Oddi sphincter pressure measurement （SOM） in the diag- nosis of Oddi sphincter of Oddi dysfunction. Methods SOM was performed in a total of 28 patients. Diagnosis was made only from standard triple-lumen SOM and the patient were treated accordingly. For each study, SO basal pressure, contraction, amplitude, and frequency were recorded. During the 48 hours after manometry, the pain scores, and serum amylase every 12 hours were recorded, and the abdominal CT after 24 hours was checked. Results All patients tolera- ted the operation, the average operation time was （16.5 -＋ 0.4） min. There was no statistically significant difference in the recordings of SO basal pressure, contraction, amplitude, and frequency between the two techniques. The accuracy of SOM was comparable to standard triple-lumen SOM, with less movement artifact. Only one patient developed post-mano- metric pancreatitis. There was no complication occurring among the other patients. Conclusion The sleeve catheter re- cords SO pressures with comparable values to standard triple-lumen SOM. The sleeve assembly potentially can replace the use of the perfused triple-lumen catheter for the objective diagnosis of SO dysfunction.