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...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。展开更多
目的针对反复右上腹痛的患者进行Oddi括约肌测压,以评价Oddi括约肌测压术(SOM)在慢性胆胰疾病诊治中的应用价值,并探讨内镜下十二指肠乳头切开术(EST)对Oddi括约肌基础压升高患者的疗效。方法回顾分析该院2012年10月-2014年9月30例慢性...目的针对反复右上腹痛的患者进行Oddi括约肌测压,以评价Oddi括约肌测压术(SOM)在慢性胆胰疾病诊治中的应用价值,并探讨内镜下十二指肠乳头切开术(EST)对Oddi括约肌基础压升高患者的疗效。方法回顾分析该院2012年10月-2014年9月30例慢性上腹痛疑似Oddi括约肌功能紊乱(SOD)的患者在内镜逆行胰胆管造影术(ERCP)检查时接受SOM的临床资料,观察Oddi括约肌基础压、收缩幅度、频率和传播方式。对Oddi括约肌基础压>40.0 mm Hg者及>30.0 mm Hg并存在血淀粉酶、脂肪酶、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(AKP)升高超过正常值2倍以上和(或)胆总管、胰管管增宽者行EST治疗,并随访其疗效。结果 30例患者SOM均存在不同程度的异常,Oddi括约肌基础压力为(36.6±21.1)mm Hg,收缩幅度为(210.6±25.7)mm Hg,收缩频率为(10.1±3.1)次/min,逆向收缩率为(55.0±8.0)%。30例患者均接受EST治疗,术后随访,其中27例(90.0%)有效。结论 SOM助于评价Oddi括约肌功能,对诊断SOD具有较大价值,测压发现Oddi括约肌基础压升高患者EST治疗可获得满意疗效。展开更多
Aim:To evaluate the outcome of transrectal irrigation(TRI)using clean tap water without salt in children with myelomeningocele and neurogenic bowel problems.Methods:40 children(21 boys and 19 girls;aged 10 mo to 11 y)...Aim:To evaluate the outcome of transrectal irrigation(TRI)using clean tap water without salt in children with myelomeningocele and neurogenic bowel problems.Methods:40 children(21 boys and 19 girls;aged 10 mo to 11 y)with myelomeningocele and neurogenic bowel dysfunction were treated with TRI given by a stoma cone irrigation set daily or every second day.A questionnaire on the effects on faecal incontinence,constipation and self-management was completed by the parents,4 mo-8 y(median 1.5 y)after start.Effects on rectal volume,anal sphincter pressure and plasma sodium were evaluated before and after the start of irrigation.Results:At follow-up,35 children remained on TRI,four had received appendicostomy,while one defecated normally.For all children but five(35/40;85%)the procedure worked satisfactorily,but a majority found the procedur every time consuming and only one child was able to perform it independently.All children were free of constipation;most(35/40)were also anal continent.Rectal volume and anal sphincter pressure improved,while plasma sodium values remained within the normal range.Conclusion:Transrectal irrigation with tap water is a safe method to resolve constipation and faecal incontinence in children with myelomeningocele and neurogenic bowel dysfunction,but it does not help children to independence at the toilet.展开更多
目的评价Oddi括约肌测压术（sphincter of Oddi manometry,SOM）在慢性胆胰疾病诊治中的应用价值。方法回顾分析我院2005年5月-2009年1月11例慢性上腹痛疑似Oddi括约肌功能紊乱（sphincter of Oddi dysfunction,SOD）在ERCP检查时接受SO...目的评价Oddi括约肌测压术（sphincter of Oddi manometry,SOM）在慢性胆胰疾病诊治中的应用价值。方法回顾分析我院2005年5月-2009年1月11例慢性上腹痛疑似Oddi括约肌功能紊乱（sphincter of Oddi dysfunction,SOD）在ERCP检查时接受SOM的临床资料,分析测压结果、ERCP诊治情况,并随访远期疗效。结果SOM结果正常2例（18.2%）,均为胆囊切除术后腹痛待查患者,未行乳头括约肌切开术（endoscopic sphincterotomy,EST）,长期随访腹痛无加重,未再因此就医。5例复发性胰腺炎和4例腹痛伴胆总管增宽的SOM均存在不同程度的异常：Oddi括约肌基础压力为（52.7±19.2）mm Hg（34-96.5mm Hg）;蠕动压力为（167.3±24.8）mm Hg（140-200mm Hg）。9例SOM结果异常者均接受EST治疗,术后随访7例（77.8%）获得良好效果,2例复发性胰腺炎再次行ERCP并放置胰管支架后获满意疗效。结论SOM有助于评价Oddi括约肌功能,尤其适用于胆囊切除术后腹痛怀疑为SODⅢ型的患者,可以帮助明确诊断SOD,指导ERCP治疗。展开更多
文摘目的针对反复右上腹痛的患者进行Oddi括约肌测压,以评价Oddi括约肌测压术(SOM)在慢性胆胰疾病诊治中的应用价值,并探讨内镜下十二指肠乳头切开术(EST)对Oddi括约肌基础压升高患者的疗效。方法回顾分析该院2012年10月-2014年9月30例慢性上腹痛疑似Oddi括约肌功能紊乱(SOD)的患者在内镜逆行胰胆管造影术(ERCP)检查时接受SOM的临床资料,观察Oddi括约肌基础压、收缩幅度、频率和传播方式。对Oddi括约肌基础压>40.0 mm Hg者及>30.0 mm Hg并存在血淀粉酶、脂肪酶、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(AKP)升高超过正常值2倍以上和(或)胆总管、胰管管增宽者行EST治疗,并随访其疗效。结果 30例患者SOM均存在不同程度的异常,Oddi括约肌基础压力为(36.6±21.1)mm Hg,收缩幅度为(210.6±25.7)mm Hg,收缩频率为(10.1±3.1)次/min,逆向收缩率为(55.0±8.0)%。30例患者均接受EST治疗,术后随访,其中27例(90.0%)有效。结论 SOM助于评价Oddi括约肌功能,对诊断SOD具有较大价值,测压发现Oddi括约肌基础压升高患者EST治疗可获得满意疗效。
文摘Aim:To evaluate the outcome of transrectal irrigation(TRI)using clean tap water without salt in children with myelomeningocele and neurogenic bowel problems.Methods:40 children(21 boys and 19 girls;aged 10 mo to 11 y)with myelomeningocele and neurogenic bowel dysfunction were treated with TRI given by a stoma cone irrigation set daily or every second day.A questionnaire on the effects on faecal incontinence,constipation and self-management was completed by the parents,4 mo-8 y(median 1.5 y)after start.Effects on rectal volume,anal sphincter pressure and plasma sodium were evaluated before and after the start of irrigation.Results:At follow-up,35 children remained on TRI,four had received appendicostomy,while one defecated normally.For all children but five(35/40;85%)the procedure worked satisfactorily,but a majority found the procedur every time consuming and only one child was able to perform it independently.All children were free of constipation;most(35/40)were also anal continent.Rectal volume and anal sphincter pressure improved,while plasma sodium values remained within the normal range.Conclusion:Transrectal irrigation with tap water is a safe method to resolve constipation and faecal incontinence in children with myelomeningocele and neurogenic bowel dysfunction,but it does not help children to independence at the toilet.
文摘目的评价Oddi括约肌测压术（sphincter of Oddi manometry,SOM）在慢性胆胰疾病诊治中的应用价值。方法回顾分析我院2005年5月-2009年1月11例慢性上腹痛疑似Oddi括约肌功能紊乱（sphincter of Oddi dysfunction,SOD）在ERCP检查时接受SOM的临床资料,分析测压结果、ERCP诊治情况,并随访远期疗效。结果SOM结果正常2例（18.2%）,均为胆囊切除术后腹痛待查患者,未行乳头括约肌切开术（endoscopic sphincterotomy,EST）,长期随访腹痛无加重,未再因此就医。5例复发性胰腺炎和4例腹痛伴胆总管增宽的SOM均存在不同程度的异常：Oddi括约肌基础压力为（52.7±19.2）mm Hg（34-96.5mm Hg）;蠕动压力为（167.3±24.8）mm Hg（140-200mm Hg）。9例SOM结果异常者均接受EST治疗,术后随访7例（77.8%）获得良好效果,2例复发性胰腺炎再次行ERCP并放置胰管支架后获满意疗效。结论SOM有助于评价Oddi括约肌功能,尤其适用于胆囊切除术后腹痛怀疑为SODⅢ型的患者,可以帮助明确诊断SOD,指导ERCP治疗。
