壶腹部胆道内支架置入术后局部微环境变化的初步研究  

An influence of biliary internal environment after metallic stent implanted through ampullae: a clinical study

作　　者：卢再鸣[1] 杨晓珍[1] 温锋[1] 梁宏元[1] 毛晓楠[1] 郭启勇[1] 

机构地区：[1]中国医科大学附属盛京医院放射科,辽宁沈阳110004

出　　处：《中国临床医学影像杂志》2009年第12期914-916,共3页Journal of China Clinic Medical Imaging

基　　金：辽宁省创新团队项目(2007T182)

摘　　要：目的:探讨低位恶性胆道梗阻的患者行壶腹部胆道内支架置入术后,胆管局部微环境的改变状况。方法:15例因壶腹周围恶性病变造成低位胆道梗阻的患者,经皮置入金属胆道内支架,内支架跨越壶腹部,分别检测支架置入术术前和术后胆汁的脂肪酶、淀粉酶、酸碱度,并对胆汁进行细菌培养。支架置入后患者服用核素,检查是否存在肠胆返流。结果:行胆道支架置入术后,患者胆汁内脂肪酶、淀粉酶明显升高,pH值降低,胆汁内有肠道内细菌生长。大部分患者存在肠胆返流。结论:壶腹部胆道内支架置入后胆汁成分、酸碱度均明显改变,胰液、肠液可能逆入胆道,需要临床关注。Objective： To investigate the relationship between the stent implatation and the changes of microenvironment of the bile duct. Methods： Fifteen cases with low malignant obstruction of bile duct were implanted with metallic stent. The bile was gathered before and after the stenting, and then the volume of AMS, LPS, pH value was measured, and the germiculture was performed. Oral 99mTc was also performed after the biliary stenting. Results： The AMS/LPS was higher than before biliary stenting, and pH value was lower than before as well. Tile result of germiculture was positive. Oral 99mTc proved that the enteric bile reflux existed. Conclusion： Biliary internal environment was changed apparently after metallic stent implanted through ampullae. The enteric bile reflux and the pancreatic bile reflux should be considered when the biliary stent has to be implanted through ampullae.

关 键 词：消化系统肿瘤 黄疸 阻塞性 支架 放射学 介入性 

分 类 号：R735[医药卫生—肿瘤] R595[医药卫生—临床医学]