吗啡、山莨菪碱及硫酸镁对Oddi括约肌压力的影响

Effect of Morphine,Anisodamine and Magnesium Sulfate on the Sphincter of Oddi

目的经胆道镜行Oddi括约肌(SO)测压,观察常规剂量吗啡对SO的作用,以及常规剂量山莨菪碱、硫酸镁对吗啡的拮抗作用。方法胆道术后留有T管的病人共30例,随机分为对照组、山莨菪碱组、硫酸镁组,测定用药前后的SO基础压、收缩波幅、收缩频率、收缩间期及胆总管压。结果肌注吗啡后SO基础压、收缩幅度和胆总管压力均明显升高,SO收缩频率明显增快;肌注15mg山莨菪碱,SO基础压和收缩幅度明显下降;口服25%硫酸镁10g,SO收缩幅度明显下降。结论常规剂量的吗啡,可提高胆总管压、SO基础压、收缩波幅及收缩频率;山莨菪碱、硫酸镁可以拮抗吗啡对SO的激动作用。

Objective Taking the manometer on Sphincter of Oddi（SO） via choledochofiberoscope, observing the role of rule dose morphine on SO, and the antagonism of anisodamine and magnesium sulfate on morphine. Methods All of 30 patients who had post-operation on biliary tract with T-tube were randomly assigned to anisodamine group, magnesium sulfate group and control group. The SO basal pressure（SOBP）, SO contractive amplitude （SOCA）, SO contraction frequency（SOF）, SO contractive duration（SOCD） and common bile duct pressure（CBDP） were measured before or after the administration. Results After the administration of morphine, there was a obvious increase of SOBP, SOCA and SOF; after the administration of anisodamine, there was a obvious decrease of SOBP and SOCA; after the administration of 10g of magnesium sulfate, there was a obvious decrease of SOCA. Conclusion Morphine of rule dose can significantly increase SOBP, SOCA, SOF and CBDP, anisodumine and magnesium sulfate can resist the exciting role of morphine on SO.