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1.
200例择期胆囊切除+术中胆道造影患者分二组;芬太尼17ug/kg静注(F组,n=100)、哌替啶1mg/kg静注。评价两种麻醉性镇痛药致Oddi括约肌痉挛的发生率,结果:8例病人造影剂不能通过Oddi括约肌、十二指肠不显影,胆总管下端显示“鸟嘴样”或“假结石”影像,后者3例病人胆总管探查阴性,静注纳络酮0.4mg后,全部病例造影剂顺利进入十二指肠。结论:硬膜外麻醉辅用小剂量芬太尼/哌替啶时Odd 相似文献
2.
Abstract Nitric oxide (NO) plays an important physiological role in regulating gastrointestinal motility. Involvement of endogenous NO was evaluated in the response to non-adrenergic, non-cholinergic (NANC) nerve stimulation of the dog sphincter muscle of Oddi. Transmural electrical stimulation (TES), nicotine (10?5M) and K+ (10 mM) produced only a relaxation in the sphincter muscle strips contracted with substance P, which was not potentiated by atropine. The TES-induced relaxation was abolished by tetrodotoxin (3 times 10?7 M) and oxyhaemoglobin (1.6 times 10?5 M), but not affected by atropine (10?7 M), propranolol (10?7 M), phentolamine (10?7 M), indomethacin (10?6 M), chole-cystokinin (CCK, 10?8 M) and vasoactive intestinal polypeptide (VIP, 10?8 M). The relaxation was also abolished by treatment with NG-nitro-L-arginine (L-NA, 10?5 M), an NO synthase inhibitor. Nicotine produced a transient relaxation, which was abolished by tetrodotoxin, hexamethonium (10?5 M) and L-NA, but not affected by atropine and NG-nitro-D-arginine (D-NA, 10?5 M). The addition of K+ elicited a transient relaxation, which was abolished by tetrodotoxin and L-NA. The inhibitory effects of L-NA were antagonized by L-arginine (10?3 M). The presence of neurons containing nicotinamide adenine dinucleotide phosphate (NADPH)-diaphorase was histochemically demonstrated in the sphincter of Oddi. These findings may indicate that TES, nicotine and K+ liberate NO from NANC inhibitory nerve which is involved in the relaxation of the dog sphincter of Oddi. The muscular tone does not seem to be regulated by cholinergic nerves under the experimental conditions used. 相似文献
3.
腰椎间盘突出症和马尾神经综合征 总被引:1,自引:0,他引:1
本文报告32例腰椎间盘突出症导致的马尾神经综合征。除腰痛及坐骨神经痛外,本组所有病人均存在鞍区麻木和括约肌功能障碍。根据尿便功能障碍发作程度和持续时间,本组有四种不同的临床表现类型,预后差。异较大。脊髓造影具有诊断和鉴别诊断价值,应用Omnipaaue较Conray安全。早期诊断和手术治疗,对括约肌功能、肌力和鞍区浅感觉最大程度地恢复甚为重要。 相似文献
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姜先明 《中国实用乡村医生杂志》2021,(1)
目的探讨低位直肠癌患者行保肛术后出现低位前切综合征(LARS)的危险因素。方法收集2015年1月-2019年12月在本溪市中心医院行保肛手术治疗的低位直肠癌患者421例,对患者的临床资料进行回顾性分析,并依据患者术后是否发生LARS分为LARS组106例和非LARS组315例、分析LARS发生的危险因素。结果单因素Logistic回归分析显示,年龄,术前放宁、术后恢复时间、坐骨棘间径是LARS发生的危险因素(P<0.05)。多因素Logistic回归分析显示,术前放疗.术后恢复时间、坐骨棘间径是LARS发生的危险因素(P<0.05)。结论对于低位直肠癌行保肛手术治疗患者,术前放疗.术后恢复时间.坐骨棘间径与术后LARS的发生密切相关,对存在上述危险因素的低位直肠癌患者,术前应采取针对性预防措施,或采取其他术式治疗。 相似文献
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7.
《Auris, nasus, larynx》2022,49(6):986-994
ObjectiveDysphagia is a common symptom in Parkinson's disease (PD) and it represents a negative prognostic factor because of its complications. This study is to evaluate pharyngeal dysphagia for boluses of various consistencies with Fiberoptic Endoscopic Evaluation of Swallowing (FEES) and Pharyngeal High-Resolution Manometry (PHRM) in a group of PD patients, making a comparison between the information provided by the two exams.MethodsGroup of 20 patients affected by PD was selected and initially subjected to a qualitative evaluation of the swallowing performing FEES. Subsequently, they were evaluated by PHRM to identify quantitative measures associated with pressures expressed by pharyngeal organs during swallowing. Values obtained in the study group were compared with those recorded in a group of 20 healthy subjects.ResultsStudy showed that Pmax (the maximum pressure elicited by the single pharyngeal muscle structures involved in swallowing) was significantly lower than the control group (p<0.05) for all the boluses and consistency tested, in particular for the Tongue base and the Cricopharyngeal muscle. Pmean pre-swallowing pressure (represents the mean value of a contraction in which basal and maximal pressure where normally calculated) was significantly higher compared to normal subjects for the Tongue base and the Cricopharyngeal muscle (p<0.05). Mean intra-swallowing pressure was higher for the Velopharynx and the Cricopharyngeal muscle, but lower for the tongue base. Pmax and Pmean at PHRM were altered independently to the degree of dysphagia detected at FEES, and they did not correlate either with the location of the residue or with the type of bolus. Images displayed at the FEES, found the corresponding biomechanical explanations in the PHRM, which also allowed us to quantify the extent of the dysfunction, through the calculation of the pressures generated in the various structures studied.ConclusionPHRM is particularly useful in the early detection of dysphagia, when FEES may still show no evidence of abnormal swallowing. 相似文献
8.
José Tiago Sequeira Lopes da Silva Olga González Casas Verónica Bejarano Moguel Maria Lobo Pascua Antonio López-Santamaría Redondo Remigio Cordero Torres 《Gastroenterologia y hepatologia》2013
Somatostatin and somatostatin analogues are considered very useful for the treatment of hormone producing tumors and acute variceal bleeding. They have also been proposed for the treatment of acute pancreatitis and for the prevention of post-endoscopic retrograde cholangiopancreatography pancreatitis although clinical trials have failed to show any efficacy. The authors report the case of a 45-year-old man, recently diagnosed of acromegaly, which developed an acute pancreatitis shortly after his first injection of lanreotide autogel. The patient developed a severe dilatation of his hypocontractile gallbladder with distension of the intra and extrahepatic biliary ducts, the choledochus and the main pancreatic duct, without lithiasis or other abnormalities at the papilla, which resolved spontaneously in a month. We consider that lanreotide most likely induced a functional spasm of the Sphincter of Oddi, with impairment of the biliary-pancreatic outflow, leading to an acute pancreatitis, and review the literature concerning this drug related pancreatitis. 相似文献
9.
随着社会的发展与进步,公众接触理化不良因素的机会也在增加,随之产生的是消化道恶性肿瘤发病率的提高。临床上最常见的消化道恶性肿瘤包括大肠癌,其中低位直肠癌发病率在50%以上。低位直肠癌的判断依据是与肛缘有8 cm的距离;与肛缘相距5 cm的为超低位直肠癌。直肠癌研究与治疗的最终目的是提高患者生存率和部分控制恶性肿瘤。在现代医学技术不断发展的今天,人们对直肠癌也有了更加深刻的了解,主要包括生理和解剖方面以及病理学和生理学方面。由此,更加科学的治疗方式也随之产生。新兴的治疗方式主要有腹腔镜与保肛手术治疗术。 相似文献
10.