Camilleri M
Gastroenterology Division, Mayo Clinic, Rochester, MN 55905.
Gut. 1989 Apr;30(4):468-75. doi: 10.1136/gut.30.4.468.
The aim of this study is to assess the value of jejunal manometry in the diagnosis of subacute mechanical obstruction distal to the proximal small bowel. In a retrospective review of 850 manometric tracings carried out in patients with unexplained nausea, vomiting, abdominal pain or altered bowel movements, 16 tracings were identified with features suggestive of mechanical obstruction: prolonged simultaneous contractions (PC) and postprandial clustered contractions (CC). Three patients had CC lasting less than 20 minutes: none proved to have mechanical obstruction. Among seven patients with CC lasting more than 30 minutes, three had proven mechanical obstruction, one probable adhesion obstruction, and in three no obstruction was found. All three patients with PC and three with mixed PC and CC had mechanical obstruction. The obstructed intestine manifests a variety of pressure profiles in the proximal jejunum: PC, CC, or mixed patterns. Prolonged simultaneous contractions are suggestive of distal subacute bowel obstruction; CC lasting over 30 minutes are less specific, whereas CC lasting less than 20 minutes are not associated with obstruction.
本研究的目的是评估空肠测压法在诊断近端小肠远端亚急性机械性肠梗阻中的价值。在对850例因不明原因恶心、呕吐、腹痛或排便习惯改变而行测压描记的患者进行回顾性研究时，发现16例描记具有提示机械性肠梗阻的特征：延长的同步收缩（PC）和餐后成簇收缩（CC）。3例患者的CC持续时间少于20分钟：均未证实存在机械性肠梗阻。在7例CC持续时间超过30分钟的患者中，3例已证实存在机械性肠梗阻，1例可能为粘连性肠梗阻，3例未发现梗阻。所有3例有PC的患者以及3例有PC和CC混合情况的患者均有机械性肠梗阻。梗阻肠段在近端空肠表现出多种压力模式：PC、CC或混合模式。延长的同步收缩提示远端亚急性肠梗阻；持续超过30分钟的CC特异性较低，而持续少于20分钟的CC与梗阻无关。
