【摘要】 目的 经胆道镜Oddi括约肌测压,观察常规剂量的吗啡、度冷丁、强痛定及曲吗多对Oddi括约肌运动功能的影响。方法 胆道术后留有T型管病人70例,随机分为吗啡组、度冷丁组、强痛定组及曲吗多组,测量用药前后的十二指肠压(DP)、Oddi括约肌基础压(SOBP)、收缩波幅(SOCA)、收缩频率(SOF)、收缩间期(SOD)及胆总管压(CBDP)。结果 肌注吗啡及强痛定后SOBP和SOCA升高,SOF增快,吗啡组CBDP升高(P<0.05);肌注度冷丁后各指标无明显变化;肌注曲吗多后SOBP和SOCA明显降低(P<0.05);应用各药物后收缩间期无明显变化。结论 常规剂量的吗啡及强痛定对Oddi括约肌起激动作用,常规剂量的度冷丁对Oddi括约肌无明显作用,常规剂量的曲吗多对Oddi括约肌具有抑制作用。更多还原

【Abstract】 <abstract>jective To assess the effects of intramuscularly administered analgesics (morphine, Ap-237, pethidine and tramadol) on motility of human Oddi’s sphincter. Methods A total of 70 patients who had a T tube after cholecystectomy and choledochotomy were randomized into 4 groups. The patients in the 4 groups received intramuscular administration of the 4 different analgesics, respectively. Then the Oddi’s sphincter’s basal pressure (SOBP), amplitude (SOCA), frequency of contractions (SOF), duration of contractions (SOD), duodenal pressure (DP) common bile duct pressure (CBDP) were determined by choledochoscopic manometry and analyzed. Results SOBP, SOCA and SOF significantly increased after intramuscular administration of morphine and Ap-237 (P <0. 05). CBDP markedly increased after the administration of morphine (P<0. 05). No significant changes were found after intramuscular administration of pethidine. SOBP and SOCA remarkably decreased after the administration of tramadol (P<0. 05). Conclusions The regular dose of morphine and Ap-237 increases SOBP, SOF and SOCA Meanwhile, morphine increases CBDP. These suggest that morphine and Ap-237 have excitatory effects on Oddi’s sphincter. However, pethidine has no effect and tramadol can exert inhibitory effects on Oddi’s sphincter.更多还原