乳头括约肌切开术前后胰胆管测压术

MANOMETRY OF CHOLANGIOPANCREATIC DUCT BEFORE AND AFTER ENPOSCOPIC SPHINCTEROTOMY

为探明乳头括约肌切开术（ＥＳＴ）切口大小对生理功能的影响，对３２例胰胆疾病患者检测了ＥＳＴ前后Ｏｄｄｉ括约肌（ＳＯ）压力、胰管压、胆管压，结果表明：ＥＳＴ前后压力变化大小，取决于切开范围大小。文献报道大切开（切口＞２．５ｃｍ）ＳＯ压降至０，胰胆管压也略有下降。该３２例采取中切开（切口１．５－２．０ｃｍ），切开前ＳＯ压为１．５４±０．２３ｋＰａ－１．９２±０．４５ｋＰａ，切开后降至０．６８±０．２０ｋＰａ－１．２２±０．３３ｋＰａ，胰胆管压切开前后变化不大。从保护器官生理功能来看，胰胆疾病者作ＥＳＴ切口大小应适可而止，ＳＯ压不宜降至０，除非有特殊需要，一般不宜提倡作大切开。

In order to study the effect on physiological function of the sphincter of Oddi(SO ) which results from the range of incision of endoscopic sphincterotomy (EST ) , Pressures of SO ,pancreatic duct ( PD) and common bile duct .CBD) were deteted before and after EST in 32 cases with various biliary and/or pancriatic disease. The results showed that the changes of pressures before and after EST in mid- dle range group(1. 5-2. 0cm) was 1. 54±0. 23kPa-1. 92±0. 45kPa.0. 68±0. 20kPa-1. 22 ±0. 33kPa respectively. There was significant difference in the pressors of SO before and after EST ,but no difference showed in the CBD and PD,while pressure of SO fell to 0 in large range EST group(>2. 5cm) after EST. The results indicated that large range EST should not be performed so as to protect the normal function of SO except for some especial purposes.