Barham C P, Gotley D C, Fowler A, Mills A, Alderson D
University Department of Surgery, Bristol Royal Infirmary, UK.
Gut. 1997 Aug;41(2):151-5. doi: 10.1136/gut.41.2.151.
Diffuse oesophageal spasm (DOS) is a potential cause of intermittent chest pain and/or dysphagia. In the past, the diagnosis of DOS has relied on criteria obtained from standard oesophageal manometry (more than one simultaneous contraction in a series of 10 wet swallows with the rest being peristaltic). As symptoms are intermittent, however, 24 hour manometry may well be more suited to its investigation.
To determine the ability of 24 hour manometry to detect the symptomatic contractions of DOS and to compare standard, laboratory based manometry with 24 hour manometry in its diagnosis.
Three hundred and ninety consecutive patients referred with suspected oesophageal disorders.
Standard laboratory based manometry and 24 hour outpatient manometry.
Sixteen patients were classified by 24 hour manometry as having DOS on the basis of painful contractions (spasms) of excessive duration and increased amplitude. Laboratory based manometry failed to detect the majority of these patients with DOS (14/16), and 53/55 were incorrectly labelled as having DOS on the basis of asymptomatic manometric findings.
The detection of symptomatic DOS requires 24 hour manometry.
弥漫性食管痉挛（DOS）是间歇性胸痛和/或吞咽困难的潜在病因。过去，DOS的诊断依赖于标准食管测压获得的标准（在连续10次湿吞咽中有超过一次同步收缩，其余为蠕动）。然而，由于症状是间歇性的，24小时测压可能更适合对其进行检查。
确定24小时测压检测DOS症状性收缩的能力，并在诊断中将基于实验室的标准测压与24小时测压进行比较。
390例连续转诊的疑似食管疾病患者。
基于实验室的标准测压和24小时门诊测压。
24小时测压根据持续时间过长和幅度增加的疼痛性收缩（痉挛）将16例患者归类为患有DOS。基于实验室的测压未能检测出这些患有DOS的大多数患者（14/16），并且53/55例患者基于无症状的测压结果被错误标记为患有DOS。
症状性DOS的检测需要24小时测压。
