Oddi括约肌压力测定及内镜下十二指肠乳头括约肌切开术对Oddi括约肌功能紊乱诊治的意义  

Sphincter Oddi manometry and endoscopic sphincterotomy in diagnosis and treatment of patients with sphincter of Oddi dysfunction

作　　者：李霆[1] 郭强[2] 范红[2] 唐晓丹[2] Ting Li;Qiang Guo;Hong Fan;Xiao-dan Tang(Medical Faculty of Kunming University of Science and Technology, Kunming, Yunnan 650000, China;Department of Gastroenterology, the First People’s Hospital of Yunnan Province (the Affiliated Hospital of Kunming University of Science and Technology), Kunming, Yunnan, 650000, China)

机构地区：[1]昆明理工大学医学院,云南昆明650000 [2]云南省第一人民医院(昆明理工大学附属医院)消化内科,云南昆明650000

出　　处：《中国内镜杂志》2017年第3期25-29,共5页China Journal of Endoscopy

摘　　要：目的针对反复右上腹痛的患者进行Oddi括约肌测压,以评价Oddi括约肌测压术(SOM)在慢性胆胰疾病诊治中的应用价值,并探讨内镜下十二指肠乳头切开术(EST)对Oddi括约肌基础压升高患者的疗效。方法回顾分析该院2012年10月-2014年9月30例慢性上腹痛疑似Oddi括约肌功能紊乱(SOD)的患者在内镜逆行胰胆管造影术(ERCP)检查时接受SOM的临床资料,观察Oddi括约肌基础压、收缩幅度、频率和传播方式。对Oddi括约肌基础压>40.0 mm Hg者及>30.0 mm Hg并存在血淀粉酶、脂肪酶、谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(AKP)升高超过正常值2倍以上和(或)胆总管、胰管管增宽者行EST治疗,并随访其疗效。结果 30例患者SOM均存在不同程度的异常,Oddi括约肌基础压力为(36.6±21.1)mm Hg,收缩幅度为(210.6±25.7)mm Hg,收缩频率为(10.1±3.1)次/min,逆向收缩率为(55.0±8.0)%。30例患者均接受EST治疗,术后随访,其中27例(90.0%)有效。结论 SOM助于评价Oddi括约肌功能,对诊断SOD具有较大价值,测压发现Oddi括约肌基础压升高患者EST治疗可获得满意疗效。Objective To investigate the diagnostic value of endoscopic sphineter Oddi manometry(SOM)inpatients with recurring abdominal pain and observe the value of endoscopic sphincterotomy(EST)in treatment ofpatients with sphincter of Oddi dysfunction(SOD).Methods Clinical data of30patients with chronic abdominalpain after cholecystectomy who were suspected SOD from2012October to2014September were collected andretrospectively analyzed.These patients received SOM in ERCP examination and the observation of Oddi sphincterbasal pressure,contraction amplitude,frequency and mode of transmission were carried out.The EST were carried outin patients with basal pressure of Oddi sphincter higher than40.0mmHg or higher than30.0mmHg,and the presenceof serum amylase,lipase,ALT,AST,AKP increased more than2times of the normal value and(or)of common bile duct,pancreatic duct widening.Result The SOM of all the30patients were all abnormal.The basal pressure of Oddisphincter,the contraction amplitude,the contraction frequency and the reverse shrinkage were(36.6±21.1)mmHg,(210.6±25.7)mmHg,(10.1±3.1)times/min and(55.0±8.0)%.All the patients were treated with EST,of which27cases(90.0%)received good results.Conclusion SOM is helpful in evaluation of Oddisphincter function,it is ofgreat value in diagnosis of SOD.EST treatment obtained satisfactory effect in patients with elevated basal pressure ofOddi sphincter.

关 键 词：ODDI括约肌功能紊乱 Oddi括约肌压力测定 内镜下十二指肠乳头切开术 

分 类 号：R57[医药卫生—消化系统]