豚鼠不全性胆道梗阻早期Oddi括约肌功能的变化  

Changes of function of sphincter of Oddi after short-term partial bile duct obstruction

作　　者：徐贤刚[1] 石承先[1] 汤可立[1] 钟浩丽 张德林[1] 张帅民[1] 罗丹[1] 

机构地区：[1]贵州省人民医院肝胆外科,贵州贵阳550002 [2]贵州省贵阳市妇女儿童医院麻醉科,贵州贵阳550001

出　　处：《中国普通外科杂志》2015年第2期221-225,共5页China Journal of General Surgery

基　　金：贵州省高层次人才基金资助项目[黔科合人字(2012)22号

摘　　要：目的:观察豚鼠胆道不全性梗阻后早期Oddi括约肌(SO)肌电活动及压力的变化。方法:16只英国短毛豚鼠随机均分假手术组与模型组,分别行假手术与制作胆总管不全性梗阻模型,期间测定胆总管直径;术后1周,再次检测两组胆总管直径、肝功能指标、SO肌电活动与动力学指标。结果:术后假手术组胆总管直径无明显改变(P>0.05),而模型组较术前明显增大(P<0.05)。与假手术组比较,模型组血清胆红素、肝酶水平明显升高(均P<0.05);SO快波幅度和慢波振幅显著降低(均P<0.05),但快波和慢波频率无统计学差异(均P>0.05);SO基础压明显升高,但SO峰压明显降低(均P<0.05),而SO收缩频率无统计学差异(P>0.05)。结论:不全性胆总管梗阻可使豚鼠SO快、慢波振幅降低,SO基础压升高、收缩峰压降低,这可能是胆道不全性梗阻时易诱发急性胆源性胰腺炎的重要机制之一。Objective： To observe the changes of myoelectric activity and pressure in sphincter function of Oddi（SO） after short-term partial bile duct obstruction in guinea pigs.Methods： Sixteen English short-hair guinea pigs were equally randomized into sham operation group and model group, and underwent sham operation and establishment of partial obstruction of the common bile duct（CBD） respectively, during which, the CBD diameters were measured. At one week after operation, the CBD diameters were measured again, and the liver function parameters, as well as the electrical activity and dynamic variables of SO were determined.Results： After operation, the CBD diameter in sham operation group showed no significant change（P〉0.05）, but it was significantly enlarged in model group（P〈0.05）. In model group compared with sham operation group, the serum levels of bilirubin and liver enzymes were significantly increased（all P〉0.05）; the voltage amplitudes ofboth rapid and slow waves of SO were significantly decreased（both P〈0.05）, while the frequencies of them had no significant difference（both P〈0.05）; the basal SO pressure was increased but peak SO pressure was decreased significantly（both P〈0.05）, while the SO contraction frequency showed no obvious difference（P〉0.05）. Conclusion： Partial CBD obstruction can cause decrease of voltage amplitudes of rapid and slow waves, basal pressure increase and peak pressure decrease in SO, and these changes may be one of the important mechanisms responsible for being prone to acute biliary pancreatitis in partial CBD obstruction.

关 键 词：胆汁淤积 奥狄括约肌功能障碍 豚鼠 

分 类 号：R657.4[医药卫生—外科学]