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Efficiency of drug and endosepic sphincterotomy for sphincter of Oddi dysfunction
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摘要: 了解药物与内镜下十二指肠乳头括约肌切开术(EST)对胆囊切除术后Odd i括约肌功能失调(SOD)的疗效。以临床诊断的SOD患者先行药物治疗一周,无效者再行EST治疗,观察其疗效。在45例药物治疗的患者中,有效者仅11例,其有效率为24.4%;而在34例药物治疗无效后经EST治疗的患者中,有效者为31例,其有效率为91.2%,明显优于药物治疗(P<0.005)。EST术中和术后出现并发症4例,其发生率为11.8%。EST是药物治疗SOD无效时的最佳手段。
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关键词:
- Oddi括约肌功能失调 /
- 药物治疗 /
- 内镜下乳头括约肌切开术
Abstract: To investigate the effects of drug and endoscopic sphincterotomy (EST) in post-cholecystectomy patients with sphincter of Oddi dysfunction (SOD) 45 cases with SOD, which had been diagnosed clinically, were divided into two groups.All the 45 patients were treated with drug initially.Then 34 patients who had no response to drug treatment were treated with EST one week later.The utility rate of drug group and EST group is 24.4% (11/45) and 91.2% (31/34) respectively.The therapeutic effect of EST group was significantly higher than that of drug group (P<0.005) .In EST group, 4 patients (11.8%;4/34) had complications during or after EST operation.EST is the best therapeutic method for SOD, especially when drug has no efficiency.-
Key words:
- sphincter of Oddi dysfunction /
- drug therapy /
- endoscopic sphincterotomy
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[1]Hogan WJ, Geenen JE.Biliary Dyskineia[J].Endoscopy, 1998, 26∶179-183. [2]许国铭, 邹多武, 李兆申, 等.Oddi括约肌测压及内镜下十二指肠乳头切开术对Oddi括约肌运动功能障碍诊治的意义[J].中华消化杂志, 1997, 17 (5) ∶262-264. [3]Toouli J, Roberts-Thomsom IC, Kellow J, et al.Manometry basedrandomized trial of endoscpic sphincterotomy for sphincter of Oddidysfunction[J].Gut, 2000, 46∶98-102. [4]Linder JD, KlapowJC, Linder SD, et al.Incomplete response to en-doscpic sphincterotomy in patients with sphincter of Oddi dysfunc-tion:evidence for a chronic pain disorder[J].Am J Gastroenterol, 2003, 98 (8) ∶1738-1743. [5]Parajapati DN, Hogan WJ.Sphincter of Oddi dysfunction and otherfunctional biliary disorders:evaluation and treatment[J].Gastroen-terol Clin N Am, 2003, 32 (2) ∶601-618. -
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