门奇静脉断流术前后Oddi括约肌运动功能的改变  

Motor function of gallbladder before and after portal azygous disconnection

作　　者：金红旭[1] 吴硕东[2] 张雪峰[1] 陈宪英[3] 张国旭[3] 

机构地区：[1]沈阳军区总医院普通外科,110016 [2]中国医科大学附属第二医院普外二科 [3]沈阳军区总医院核医学科,110016

出　　处：《中华实验外科杂志》2004年第12期1420-1421,i020,共3页Chinese Journal of Experimental Surgery

摘　　要：目的　阐明人迷走神经在Oddi括约肌 (SO )运动中的作用。方法　应用99mTc EHI DA肝胆动态显像的方法 ,检测 2 3例手术前后肠道时间放射性曲线 ,分析注射99mTc EHIDA 3 0min后的放射性计数 (BORC 3 0 )、潜伏期 (BOLP)、脂餐后放射性计数快速增加期 (BOEP)、增加量(BOEI)、增加率 (BOER)。结果　Hassab手术组 :术后BORC 3 0min明显增加 (615 9.4± 175 1.3vs42 5 7.8± 2 42 3 .9,P <0 .0 1) ,BOLP明显延长 (13 .86± 5 .13vs 2 .2 8± 1.65 ,P <0 .0 1) ;手术前后的BOEP、BOEI、BOER差异无统计学意义 (P >0 .0 5 )。栓塞术组 :手术前后各项指标差异无统计学意义 (P >0 .0 5 )。结论　人迷走神经在SO运动中起重要的调节作用 ,切断迷走神经使消化间期SO张力减低 ,餐后SO舒张延迟 ,但不影响SO的舒张程度。Objective To demonstrate the function of vagus in Oddi's sphincter (SO) motility.Methods 99m Tc EHIDA hepatobiliary dynamic imaging method was used to detect the time activity curve of bowel in 23 patients before and after operation.The radiocounting being injected 99m Tc EHIDA 30 min later (BORC 30 min),latent period (BOLP),the period of radiocounting that rapidly increases after fat meal (BOEP min),radiocounting increment within BOEP (BOEI),radiocounting increment rate within BOEP (BOER) were analyzed.Results In Hassab group,BORC 30 min after operation was increased obviously as compared with that before operation (6?159.4± 1?751.3 vs 4?257.8± 2?423.9, P < 0.01); BOLP was prolonged obviously (13.86± 5.13 vs 2.28± 1.65, P < 0.01); There was no significant difference in BOEP,BOEI,BOER before and after operation.In Vena coronaria ventriculi embolization group,There was no significant difference in all parameters before and after operation.Conclusion Human vagus nerve play an important role in adjusting the function of SO motility.The vagus nerve disconnection could decrease the tension of SO in interdigestive phase and delay SO relaxation after meal,but had no obvious effect on the relaxation degree of SO.

关 键 词：手术前后 ODDI括约肌 迷走神经 餐后 门奇静脉断流术 改变 运动功能 动态 计数 

分 类 号：R657.3[医药卫生—外科学]