Oddi括约肌压力测定及内镜下十二指肠乳头括约肌切开术对Oddi括约肌功能紊乱诊治的意义

发布时间：2018-04-15 00:09

本文选题：Oddi括约肌功能紊乱 + Oddi括约肌压力测定　；参考：《中国内镜杂志》2017年03期

【摘要】：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。
[Abstract]:Objective to evaluate the value of Oddi sphincter manometry in the diagnosis and treatment of chronic biliary and pancreatic diseases in patients with recurrent right epigastric pain.To evaluate the efficacy of endoscopic duodenal papillectomy (est) in patients with elevated basal sphincter pressure in Oddi.Methods from October 2012 to September 2014, 30 patients with chronic epigastric pain suspected Oddi sphincter dysfunction were examined with SOM during endoscopic retrograde cholangiopancreatography (ERCP). The basic pressure and contraction of Oddi sphincter were observed.Frequency and mode of transmissionPatients with Oddi sphincter basal pressure of 40.0 mm Hg and 30.0 mm Hg with serum amylase, lipase, alanine aminotransferase (alt), aspartate aminotransferase (alt) and alkaline phosphatase (ALP) were treated with EST.The curative effect was followed up.Results the basal pressure of oddi sphincter was 36.6 卤21.1)mm Hg, the contraction amplitude was 210.6 卤25.7)mm Hg, the contractile frequency was 10.1 卤3.1 times / min, and the contractile rate was 55.0 卤8.0 / min. All 30 patients were treated with EST, and 27 of them were followed-up.Conclusion SOM is helpful to evaluate the sphincter function of Oddi and has great value in the diagnosis of SOD. EST therapy in patients with Oddi sphincter base pressure elevation can obtain satisfactory curative effect.
【作者单位】：昆明理工大学医学院;云南省第一人民医院(昆明理工大学附属医院)消化内科;
【分类号】：R657.4

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