EUS联合Oddi括约肌压力测定在胆总管扩张患者中的应用价值

Endoscopic ultrasonography( EUS) combined with determination of Oddi sphincter in common bile duct expansion

目的探讨超声内镜(EUS)联合Oddi括约肌压力测定对胆总管扩张的诊断价值。方法将100例经体外超声、CT或内镜逆行性胰胆管造影术(MRCP)等检查疑似诊断胆总管扩张患者作为观察对象,所有患者均接受EUS检查、治疗性经内镜逆行性胰胆管造影术检查及Oddi括约肌压力测定,以治疗性ERCP检查结果为确诊标准,对比单纯EUS检查及EUS联合Oddi括约肌压力测定对胆总管扩张的诊断价值。结果联合EUS检查及Oddi括约肌压力测定对胆总管扩张的诊断特异度高于EUS检查(P<0.05)。同时,EUS检查及联合EUS检查与Oddi括约肌压力测定对胆总管扩张均存在诊断价值(P<0.01),以联合EUS检查与Oddi括约肌压力测定的诊断价值最高。此外,两种检查手段并发症发生率比较,差异无统计学意义(P>0.05)。结论在胆总管扩张的诊断中,EUS联合Oddi括约肌压力测定具有明确的诊断价值,且并不增加检查并发症发生率。

Objective To probe into the diagnostic value of endoscopic ultrasonography（ EUS） combined with determination of Oddi sphincter in common bile duct expansion. Methods One hundred cases of suspected diagnosis of common bile duct expansion and who were taken as the research objects,all patients received EUS examination,determination of Oddi sphincter and the therapeutic endoscopic retrograde pancreatic angiography（ ERCP）. Then,the pure EUS examination and combined Oddi sphincter EUS in the diagnosis of common bile duct expansion value were compared according to the therapeutic ERCP findings as the diagnosis standards. Results The diagnostic specificity of combined EUS examination and determination of Oddi sphincter were higher than that of the EUS examination（P〈0. 05）. At the same time,there were both diagnostic value in EUS examination and combined EUS examination and determination of Oddi sphincter in common bile duct expansion（P〈0. 01） which the diagnostic value of EUS examination and determination of Oddi sphincter was highest. In addition,there was no statistically significant difference of inspection methods comparative incidence of complications（P〈0. 05）. Conclusion In the diagnosis of common bile duct expansion,EUS joint determination of Oddi sphincter has definite diagnosis value,check and did not increase the incidence of complications.