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

摘要

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 di-agnosis of common bile duct expansion value were compared according to the therapeutic ERCP findings as the diagnosis stand-ards.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 de-termination of Oddi sphincter was highest.In addition,there was no statistically significant difference of inspection methods compara-tive 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.%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。