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目的:探讨利多卡因对兔胰管括约肌压力和造影剂及胰管结扎相关胰腺炎的影响.方法:日本大耳兔24只随机分为4组,每组6只.采用300 g/L的泛影葡胺0.5 mL/kg经兔胰管内逆行注射+胰管阻塞的方法造模.Ⅰ,Ⅱ组造模前分别用利多卡因或蒸馏水在胰管远端括约肌处进行局部喷洒,观察其对于兔胰管括约肌压力的影响及术后24 h胰腺病理形态学研究.Ⅲ组只进行胰管括约肌测压,Ⅳ组为对照组,只做开腹术.结果:术前利多卡因乳头局部喷洒组与蒸馏水喷洒组相比,术后24 h胰头部分的病理组织学评分结果表明胰腺的病理改变主要表现为轻微的水肿和炎细胞浸润,其水肿、炎细胞浸润、出血以及坏死的程度显著减轻(水肿:0.83±0.75 vs 2.83±0.41:炎细胞浸润:1.33±0.52 vs 3.00±0.00:出血:0.00±0.00 vs 0.67±0.52:坏死:0.17±0.41 vs 1.50±0.55,均P<0.05).利多卡因乳头局部喷洒组与蒸馏水喷洒组及单纯测压组相比,利多卡因可显著降低胰管括约肌压力,差异有统计学意义(19.98±6.47 vs 34.77±8-36,32.67±7.79,均P<0.05).结论:利多卡因在胰管远端括约肌的乳头部喷洒,可以明显降低括约肌压力,有效预防造影剂及胰管结扎所致胰腺炎.
Objective: To investigate the effect of lidocaine on pancreatic duct sphincter pressure and contrast-induced pancreatic duct ligation-related pancreatitis.METHODS: Twenty-four Japanese large-eared rabbits were randomly divided into 4 groups with 6 rats in each group.Using 300 g / L Pancreatic glargine 0.5 mL / kg by retrograde injection of pancreatic duct in rabbits + pancreatic duct obstruction modeling.Ⅰ, Ⅱ group were premedication with lidocaine or distilled water in the distal pancreatic duct sphincter at the local spray to observe its On the pressure of the pancreatic duct sphincter in rabbits and the histopathology of the pancreas at 24 h postoperatively.Meanwhile, the pancreatic duct sphincter pressure was measured only in group Ⅲ and the control group only as the open operation.Results: The preoperative lidocaine nipple Compared with distilled water spraying group, the histopathological score of pancreas at 24 h after operation showed that the pathological changes of pancreas mainly showed mild edema and infiltration of inflammatory cells with the degree of edema, inflammatory cell infiltration, hemorrhage and necrosis (Edema: 0.83 ± 0.75 vs 2.83 ± 0.41: inflammatory cell infiltration: 1.33 ± 0.52 vs 3.00 ± 0.00: hemorrhage: 0.00 ± 0.00 vs 0.67 ± 0.52: necrosis: 0.17 ± 0.41 vs 1.50 ± 0.55, all P <0.05) Lidocaine nipple local spray group and distilled water spray group and simple manometry Lidocaine can significantly reduce the pressure of pancreatic duct sphincter, the difference was statistically significant (19.98 ± 6.47 vs 34.77 ± 8-36,32.67 ± 7.79, all P <0.05) .Conclusion: Lidocaine in the pancreatic duct far Spinal sphincter spray, can significantly reduce the pressure on the sphincter, effectively preventing pancreatitis caused by contrast medium and pancreatic duct ligation.