Stanghellini V, Cogliandro R, Cogliandro L, De Giorgio R, Barbara G, Salvioli B, Corinaldesi R
Department of Internal Medicine, University of Bologna, Italy.
Dig Liver Dis. 2000 Aug-Sep;32(6):532-41. doi: 10.1016/s1590-8658(00)80011-0.
Digestive symptoms suggestive of intestinal motor disorders, such as abdominal pain and distension, fullness, vomiting, constipation and diarrhoea, are very common and non-specific, and may be clinical manifestations of both organic and functional diseases. Both radiology and endoscopy are important in the diagnosis of structural gastrointestinal lesions that can affect motility and offer indirect signs of impaired gastrointestinal functions, but the diagnosis of gut motility disorders currently relies on the manometric assessment of contractile activities. Small bowel manometry helps to identify normal motility features and consequently to identify abnormal motor patterns. Small bowel manometry can help to differentiate mechanical obstruction from pseudo-obstruction and neurogenic from myogenic motor disorders. Manometry is an invasive technique which is not well accepted by patients and requires specific skills from investigators. Also, manometric assessment is limited to referral centres with a specific interest in the field of digestive functions, in general, and motility, in particular. Only patients who remain undiagnosed after extensive traditional work-up and fail repeated courses with medical therapy should be referred for the manometric test. Understanding the underlying pathophysiologic mechanisms of abnormal motility and developing new therapies are the goals of the current research in this fascinating field of medicine.
提示肠道运动障碍的消化系统症状，如腹痛、腹胀、饱胀感、呕吐、便秘和腹泻，非常常见且不具特异性，可能是器质性疾病和功能性疾病的临床表现。放射学和内镜检查对于诊断可影响运动并提供胃肠功能受损间接征象的结构性胃肠道病变很重要，但目前肠道运动障碍的诊断依赖于对收缩活动的测压评估。小肠测压有助于识别正常的运动特征，从而识别异常的运动模式。小肠测压有助于区分机械性肠梗阻和假性肠梗阻，以及神经源性和肌源性运动障碍。测压是一种侵入性技术，患者接受度不高，且需要研究者具备特定技能。此外，测压评估一般仅限于对消化功能领域，特别是运动功能有特定兴趣的转诊中心。只有在经过广泛的传统检查仍未确诊且多次药物治疗无效的患者才应转诊进行测压检查。了解异常运动的潜在病理生理机制并开发新的治疗方法是这个引人入胜的医学领域当前研究的目标。
