早期夹闭T型管对胆道功能的影响

Influence of early clamping of T-tube on biliary tract function of patients

[目的]探讨早期夹闭T型管对胆道功能的影响。[方法]将择期行胆总管探查的40例病人随机分为对照组和实验组,各20例,对照组采取常规方法夹闭T型管,实验组根据术后胆总管压力监测结果确定夹管。术后第1天、第3天、第7天经T管监测胆总管压力、流量、流量阻力,比较两组病人血总胆汁酸、直接胆红素及碱性磷酸酶(ALP)、γ-谷氨酰转移酶(GGT)水平。[结果]实验组术后第3天、第7天胆管流量阻力较对照组明显降低,胆管流量明显增加,胆总管压力明显降低(P<0.05);实验组血总胆汁酸、直接胆红素、ALP、GGT水平与对照组比较无统计学意义(P>0.05)。[结论]胆总管探查术后根据胆管压力早期夹闭T型管可以改善胆道流变学,促进胆道功能恢复。

Objective： To probe into the influence of early clamping of T- tube based on pressure on biliary tract function of patients. Methods： A total of 40 patients who were about to undergo exploration of common bile duct selectively were divided into control and test group randomly （20 cases each）. Patients of control group were clamped T - tube as in routine measures. Patients of test group were clamped T- tube based on monitoring outcomes of postoperative common bile duct pressure. Common bile duct pressure, flow rate and flow rate resistance of common bile duct of patients were monitored via T- tube on the first, the third and the seventh postoperative day. And the levels of blood total bile acid, direct bilirubin, alkaline phosphatase and γ- glutamyltransferase of both groups patients were compared with each other. Results： Compared with control group cases, flow resistance of bile duct was significantly decreased, bile flow was increased and common bile duct pressure was decreased on the third and the seventh day after operation in test group patients （P〈0.05）. But serum total bile acid and direct bilirubin levels, serum ALP and GGT levels were not increased at all （P 〉0.05）. Conclusion： To clamp T- tube early based on bile duct pressure for patients after undergoing exploration of common bile duct may improve biliary tract rheological disfunction, and promote the recovery of biliary tract function of them.