经胆道镜测压观察硝酸甘油等对Oddi括约肌的作用  

Clinical study of the effects of nitroglycerin, cisapride, morphine and magnesium suifate on sphincter of Oddi by biliary manometry via choledochofiberscope

作　　者：吴硕东[1] 金俊哲[1] 姜锡然[1] 张强[1] 王伟[1] 

机构地区：[1]中国医科大学第二附属医院外科,110003

出　　处：《消化外科》2002年第1期40-42,共3页Journal of Digestive Surgery

摘　　要：目的 用经胆道镜测压方法观察硝酸甘油、西沙必利。吗啡对Oddi括约肌（SO）的作用及硫酸镁对吗啡的拮抗作用。方法 选择胆道术后患者,用经胆道镜低顺应性灌注式三腔管胆道压力测定方法,测用药前后十二指肠压力（DP）、SO基础压力（SOBP）及收缩幅度（SOCA）和胆总管压力（CBDP）。结果 硝酸甘油组、西沙必利组SOBP和SOCA明显下降,吗啡组SOBP和SOCA明显升高,再使用硫酸镁后,则明显降低。结论 临床常规剂量下硝酸甘油和西沙必利均有降低SOBP和SOCA的作用,吗啡有明显增加SOBP和SOCA的作用,硫酸镁可以拮抗吗啡对SO作用。Objective To evaluate sphincter of Oddi manometry via choledochofiberscope and observe the action of cisapride, nitroglycerin, morphine and magnesium sulfate on sphincter of Oddi (SO) via choledochofiberscope SO manometry. Methods Fifty patients were divided into 5 groups at random: control group, nitroglycerin group, cisapride group, morphine group and magnesium sulfate group. The apparatus used were PC polygram HR, PENTEX choledochofiberscope. Duodenal pressure, SO basal pressure, SO contractile amplitude and common bile duct pressure were measured. The dosage of various drugs used were: 0.5 mg nitroglycerin sublingually; 10 mg cisapride orally; 10 mg morphine intramuscularly; and 40 ml of 25% magnesium sulfate orally. Nothing was given in the control group. Manometry study was repeated 10-60 minutes after the drugs were administered. Results The results (mmHg) were: 0.62±2.86, 2.49±9.05, 2.07±5.29, 0.65±2.85 in control group; - 1.13±2.65, -23.07±24.18, -20.72±26.10, -2.04±4.27 in nitroglycerin group; 2.00±4.92, -14.99±19.94, -19.44±24.33, 1.05±3.13 in cisapride group; 5.01±6.96,15.40±15.44, 47.90±32.08, 3.91±4.28 in morphine group, 3.31± 11.30,23.27±30.91,80.08±54.06,3.34±4.97, 5.15±14.97, -7.40±24.17, -71.74±66. 87, - 1.78±6.35 in magnesium sulfate group. Conclusions Nitroglycerin and Cisapride can reduce SOBP and SOCA in clinical common dose, morphine can increase SOBP and SOCA, magnesium sulfate can reduce its.

关 键 词：胆道镜 Oddi括约肌压力 硝酸甘油 西沙必利 吗啡 硫酸镁 胆道手术 胆道动力学 

分 类 号：R657.4[医药卫生—外科学] R96[医药卫生—临床医学]