胆道口括约肌功能障碍在胆囊切除术后再发胆总管结石发病机制中的作用  

Significance of sphincter of oddi dysfunction in the recurrence of choledocholithiasis after cholecystectomy

作　　者：张莉[1] 江堤[1] 苏剑东[1] 孙贤久[1] 刘思纯[2] 

机构地区：[1]东莞东华医院消化内科,523000 [2]中山大学附属第一医院消化内科,广州510080

出　　处：《中华普通外科学文献（电子版）》2016年第4期298-300,共3页Chinese Archives of General Surgery(Electronic Edition)

基　　金：东莞市科技局一般项目(20131051010243)

摘　　要：目的探讨胆道口括约肌功能障碍(SOD)在胆囊切除术后再发胆总管结石发病机制中的作用。方法选择2012年6月至2015年6月收治的胆囊切除术后再发胆总管结石患者24例(再发组)、未行胆囊切除术的胆总管结石患者20例(对照组)以及胆囊切除术后胆总管残余结石患者18例(残石组),应用Mano Scan胆道口括约肌测压系统对以上患者分别进行直接胆道测压,测定胆道口括约肌的基础压(SOBP)、收缩频率(SOF)、幅度(SOCA)等。结果三组SOBP、SOF比较差异均有统计学意义(F=8.584、14.690,P=0.001、0.001),而SOCA在三组间差异无统计学意义(F=2.572,P=0.087)。与对照组和残石组比较,再发组患者的SOBP(t=3.709、2.998,P=0.001、0.004)、SOF(t=4.663、4.167,均P<0.01)水平升高,差异有高度统计学意义(P<0.01)。结论胆道口括约肌功能障碍在胆囊切除术后再发结石的发病机制中发挥一定作用。Objective To explore the function of sphincter of oddi dysfunction （SOD） in the recurrence of choledocholithiasis after cholecystectomy. Methods Between June 2012 and June 2015, sixty？two cases were enrolled, with 24 of recurrent bile duct stones after cholecystectomy （recurrence group）, 20 without gallbladder excision operation of common bile duct stones （control group）, and 18 cases after cholecystectomy with residual stone （residual group）. The direct biliary manometry including the sphincter Oddi basal pressure （SOBP）, sphincter contraction amplitude （SOCA） and sphincter contraction frequency （SOF） were measured by ManoScan measuring system. Results The differences of SOBP and SOF among the three groups were statistically significant （F=8.584, 14.690, P=0.001, 0.001）, while there was no significant difference among the three groups in SOCA （F=2.572, P=0.087）. Compared to the control group and residual group, SOBP and SOF in the recurrence group were higher, with statistically significant difference （t=3.709, 2.998, P=0.001, 0.004; t=4.663, 4.167, both P〈0.01）. Conclusion The sphincter of oddi dysfunction plays a role in the recurrence of choledocholithiasis after cholecystectomy.

关 键 词：奥狄括约肌功能障碍 胆总管结石 复发 胆道测压 

分 类 号：R657.42[医药卫生—外科学]