内镜下乳头括约肌小切开术联合球囊扩张术对胆囊储存及排空功能的影响  

Effect of Small Endoscopic Sphincterotomy Combined with Endoscopic Papillary Balloon Dilation on the Storage and Emptying Function of Gallbladder

作　　者：赵萌萌 杨荟玉[1] 陈永忠[1] 刘冰熔[1] ZHAO Mengmeng;YANG Huiyu;CHEN Yongzhong;LIU Bingrong(Department of Gastroenterology,the First Affliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院消化内科,河南郑州450052

出　　处：《河南医学研究》2021年第7期1161-1165,共5页Henan Medical Research

基　　金：国家自然科学基金面上项目(81870454);河南省科技创新杰出人才项目(184200510020);河南省杰出外籍科学家工作室项目(GZS2020006)。

摘　　要：目的探讨内镜下乳头括约肌小切开术(sEST)联合球囊扩张术(EPBD)对胆囊储存及排空功能的影响。方法选取2018年1月至2020年5月于郑州大学第一附属医院接受sEST联合EPBD(球囊直径≤12 mm)取石的30例胆总管结石患者,根据是否合并胆囊结石分为合并胆囊结石组(9例)和不合并胆囊结石组(21例),选取20例同期健康体检者为对照组。采用超声测量胆囊空腹容积(FV)及脂餐后120 min内每隔30 min的胆囊残余容积(RV_(1)、RV_(2)、RV_(3)、RV_(4))。计算胆囊排空率(EF_(1)、EF_(2)、EF_(3)、EF_(4))、最大排空率(EF max)及相邻时间点的排空率之差(EF 2-EF_(1)、EF_(3)-EF_(2)、EF 4-EF_(3))。比较3组胆囊储存及排空功能。结果合并胆囊结石组与不合并胆囊结石组、对照组比较,FV、RV 1及RV 3较大,EF 1较低(P<0.05)。合并胆囊结石组EF_(2)、EF_(3)及EF_(max)较不合并胆囊结石组低(P<0.05)。合并胆囊结石组EF_(4)-EF_(3)较对照组大(P<0.05)。不合并胆囊结石组与对照组相比,RV_(4)和EF_(4)-EF_(3)较大,EF_(4)较高(P<0.05)。结论sEST联合EPBD术后,不合并胆囊结石患者的胆囊储存与最大排空功能及合并胆囊结石患者的胆囊最大排空功能较健康人无明显增强或减弱,合并胆囊结石患者的胆囊储存功能增强,脂餐后30 min的胆囊排空功能减弱,但其储存胆汁的能力是否增强尚不明确。Objective To investigate the effect of small endoscopic sphincterotomy(sEST)combined with endoscopic papillary balloon dilation(EPBD)on the storage and emptying function of gallbladder.Methods The clinical data of 30 patients with choledocholithiasis who were treated with sEST combined with EPBD(balloon diameter≤12 mm)in the First Affiliated Hospital of Zhengzhou University from January 2018 to May 2020 were analyzed,and they were divided into choledocholithiasis with gallstone group(9 cases)and choledocholithiasis without gallstone group(21 cases)according to whether or not they had gallstones.Twenty healthy people were involved as control group.The gallbladder fasting volume(FV)and gallbladder residual volume(RV)repeated every 30 minutes within 120 minutes after fat meal(RV_(1),RV_(2),RV_(3) and RV_(4))were measured by ultrasonography.The gallbladder emptying rate(EF_(1),EF_(2),EF_(3) and EF_(4)),maximum emptying rate(EF max)and the difference values between neighboring time points(EF_(2)-EF_(1),EF_(3)-EF_(2) and EF 4-EF_(3))were calculated to compare the storage and emptying function of gallbladder among the three groups.Results Compared with choledocholithiasis without gallstone group and control group,the FV,RV_(1) and RV_(3) in choledocholithiasis with gallstone group were larger,and the EF 1 was lower(P<0.05).The EF_(2),EF_(3) and EF_(max) in choledocholithiasis with gallstone group were lower than those in choledocholithiasis without gallstone group(P<0.05).The EF_(4)-EF_(3) in choledocholithiasis with gallstone group was larger than that in control group(P<0.05).Compared with control group,the RV_(4) and EF 4-EF_(3) in choledocholithiasis without gallstone group were larger,and the EF_(4) was higher(P<0.05).Conclusion After sEST combined with EPBD,the gallbladder’s storage and maximum emptying function of patients with choledocholithiasis without gallstone and maximum emptying function of patients with choledocholithiasis with gallstone are not significantly enhanced or weakened compared with healthy

关 键 词：内镜下乳头括约肌小切开术 内镜下球囊扩张术 胆囊排空功能 胆总管结石 

分 类 号：R575.7[医药卫生—消化系统]