观察和检测肠胆反流现象方法学的建立  

Establishing a methodology for detection and confirmation of duodenal-biliary reflux

作　　者：吴硕东[1] 金俊哲[1] 张振海[1] 孙韶龙[1] 田雨[1] 王昊霖[1] 张立魁[1] 

机构地区：[1]中国医科大学附属盛京医院第一微创,胆道外科,辽宁省沈阳市110004

出　　处：《世界华人消化杂志》2007年第25期2737-2740,共4页World Chinese Journal of Digestology

摘　　要：目的:寻找和建立有效的观察和检测肠胆反流现象的方法.方法:对胆道术后留有T型管的患者,口服核素^(99m)Tc-DTPA和吲哚氰绿(ICG),定时留取T型管引流的胆汁进行测定;对胆道术后患者和Oddi括约肌切开(EST)术后患者给予口服稀钡胶浆,X线下观察平卧位及头低位钡剂在胆道中的显示;对胆道术后留有T型管的患者胆汁中胰脂肪酶、胰淀粉酶以检测肠胆反流.结果:核素^(99m)Tc-DTPA法简单易行、廉价、可定量、检测结果容易理解.ICG检测肠胆反流具有核素检查同样的优势,但敏感性不及核素检测.以胰淀粉酶和胰脂肪酶为标记物.肠胆反流检出率高于核素检测,但不能排除胰胆反流的影响,缺乏特异性.钡餐对肠胆反流的观察虽然可以直视观察,但仍有灵敏度不高,难定量评价的缺点.结论:观察和检测肠胆反流现象的方法中核素法更具有优越性,建立肠胆反流观察的方法学对于研究肠胆反流性疾病具有重要意义.AIM： To determine methods for detection and confirmation of duodenal-biliary reflux. METHODS： One hundred and twenty-three patients with a T tube after cholecystectomy and choledochotomy were randomly divided into reflux and non-reflux groups by measuring the amount of radioactivity of ^99mTc-DTPA, ICG, amylase, lipidase and pepsinogen Ⅱ in the bile. The incidence rate for barium in the biliary tract after barium meal examination was recorded to confirm the existence of duodenal-biliary reflux. RESULTS： The amount of radioactivity of ^99mTC- DTPA, ICG, amylase and lipidase in the bile of patients with a T tube after cholecystectomy and choledochotomy was detected to a varying extent. Radioactivity of ^99mTc-DTPA provided the most sensitive measure. CONCLUSION： Establishing a methodology for detection and confirmation of duodenal-biliary reflux has an important role in research into estimating the structure and function of the Oddi sphincter and formation of bile duct pigment stones.

关 键 词：肠胆反流 检测 方法 

分 类 号：R57[医药卫生—消化系统]