山莨菪碱等对Oddi括约肌作用的临床测压研究  

A clinical study of biliary marometry about the effect of anisodamine etc. on sphincter of ddi

作　　者：金俊哲[1] 吴硕东[2] 张强[2] 王伟 姜锡然[2] 

机构地区：[1]硕士研究生现工作单位沈阳市红十字医院普外科,110013 [2]中国医科大学第二临床学院外科,110004

出　　处：《岭南现代临床外科》2002年第4期229-231,共3页Lingnan Modern Clinics in Surgery

摘　　要：目的 用经胆道镜Oddi括约肌压力测定方法观察临床常规剂量吗啡、硝酸甘油、西沙必利、硫酸镁、山莨菪碱对Oddi括约肌作用及相互间拮抗作用。方法 选择术后患者70例,分7组;对照组1、硝酸甘油组、西沙必利组、吗啡组、对照组2、硫酸镁组和山莨菪碱组。用经胆道镜压力测定方法,测十二指肠压力、Oddi括约肌基础压力及收缩幅度和胆总管压力。结果硝酸甘油组Oddi括约肌基础压力及收缩幅度下降了(23.07±24.18)和(20.72±26.10)mmHg(P<0.05),西沙必利组下降了(14.99±19.94)和(19.44±24.33)mmHg(P<0.05),吗啡组增加了(15.40±15.44)和(47.90±32.08)mmHg(P<0.05);硫酸镁组下降了(7.40±24.17)和(71.74±66.84)mmHg(P<0.05),山莨菪碱组下降了17.00±17.49和85.34±70.49mmHg(P<0.05)。结论 临床常规剂量硝酸甘油、西沙必利可以降低Oddi括约肌基础压力及收缩幅度,临床常规剂量吗啡有升高Oddi氏括约肌基础压力及收缩幅度的作用,而硫酸镁、山莨菪碱可以拮抗吗啡对Oddi氏括约肌的作用。Objective To observe the action of cisapride, nitroglycerin, morphine, magnesium Sulfate and anisodamine in clinical common dose on Sphincter of Oddi (SO) by manometry via choledochofiberscope, and to research the resistant action of anisodamine and magnesium Sulfate to the effect of morphinum on SO. Methods 70 postoperative patients have been divided 7 groups: control group l, nitroglycerin group, cisapride group, morphine group, control group 2, magnesium Sulfate group and anisodamine group. Each patient was manometried by choledochofiberscope. The duodenal pressure (DP), SO basai pressure (SOBP), SO contractive amplitude (SOCA) and common bile duct pressure (CBDP) were measured. Results In nitroglycerin group, SOBP decreased 23. 07 ± 24. 18 mmHg (P <0. 05) and SOCA dcereased 20. 72 ±26. 10 mmHg (P <0. 05). In cisapride group, SOBP decreased 1499 ?19. 94, and SOCA decreased 19. 44 ± 24. 33 mmHg (P <0. 05). In morphine group, SOBP increased 15. 40 ± 15. 11, and SOCA increased 47. 90 ±32. 08 mmHg ( P <0. 05) . In magnesium sulfute group, SOBP decreased 7. 40 ± 24. 17 and SOCA decreased 71. 74 ± 66. 84 mmHg (P <0. 05) . In anisodamine group, SOBP decreased 17. 00 ± 17. 49, SOCA 85. 34 ±70. 49 mmHg ( P <0. 05) . Conclusion Nitroglycerin and cisapride in clinical routine dose can reduce SOBP and SOCA. Morphine in clinical routine dose canraise SOBP and SOCA Anisodamine or magnesium sulfate can antagonize morphine on sphincter of oddi.

关 键 词：胆道测压 硝酸甘油 西沙必利 吗啡 硫酸镁 山莨菪碱 ODDI氏括约肌 

分 类 号：R6[医药卫生—外科学]