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[胆囊胆总管结石术后人体Oddi括约肌运动活性与神经控制的临床研究]

[A clinical study of motor activity and neural control of human sphincter of Oddi in post-operative state of cholecystocholedocholithiasis].

作者信息

Tanaka J

机构信息

Second Department of Surgery, Jikei University School of Medicine, Tokyo.

出版信息

J Smooth Muscle Res. 1994 Aug;30(4):177-88. doi: 10.1540/jsmr.30.177.

Abstract

Intraluminal pressure of sphincter of Oddi (SO) was measured in awake patients who had undergone cholecystectomy and T-tube drainage for cholecystocholedocholithiasis. Pressure measurement was carried out using microtransducer which was inserted through sinus tract under cholangioscopy after removing T-tube. Mean value of the basal pressure was 12.0 +/- 1.5 mmHg, the amplitude of the phasic contraction was 55.2 +/- 4.4 mmHg and the frequency of the phasic contraction was 4.2 +/- 0.3 cycle/min. Intravenous administration of caerulein or atropine caused marked decrease in the amplitude and the frequency of the phasic contraction of SO, whereas pentazocine caused marked increase in the basal pressure, the amplitude and the frequency of the phasic contraction of SO. Naloxone alone did not affect the phasic contraction of SO, but it reduced the increased amplitude and frequency of the phasic contraction of SO caused by pentazocine. In conclusion, cholinergic nerves, excitatory nerves mediated by opioid receptors and non-cholinergic non-adrenergic inhibitory nerves may modulate spontaneous motor activity of human sphincter of Oddi.

摘要

对因胆囊胆总管结石接受胆囊切除术和T管引流的清醒患者测量了Oddi括约肌(SO)的腔内压力。压力测量是在拔除T管后,通过胆管镜经窦道插入微型传感器进行的。基础压力平均值为12.0±1.5 mmHg,相性收缩幅度为55.2±4.4 mmHg,相性收缩频率为4.2±0.3次/分钟。静脉注射雨蛙肽或阿托品可使SO相性收缩的幅度和频率显著降低,而喷他佐辛可使SO的基础压力、相性收缩的幅度和频率显著增加。单独使用纳洛酮不影响SO的相性收缩,但可降低喷他佐辛引起的SO相性收缩幅度和频率的增加。总之,胆碱能神经、阿片受体介导的兴奋性神经和非胆碱能非肾上腺素能抑制性神经可能调节人类Oddi括约肌的自发运动活性。

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