Pancreatic exocrine function tests are divided into direct and indirect tests. Direct test is to directly collect pancreatic juice after intubation into the duodenum, or directly stimulate pancreatic secretion with certain gastrointestinal hormones to understand its exocrine state. Its sensitivity and specificity are relatively good, but because the intubation causes some pain to the patient, it is not easy to be promoted in clinical application. Indirect tests have a variety of methods to determine pancreatic enzyme breakdown products without intubation, or to detect pancreatic enzyme breakdown products by radionuclide labeling to indirectly understand pancreatic exocrine function.Basic Information
Specialist classification: Digestive examination classification: biochemical examination
Applicable gender: whether men and women apply fasting: fastingTips: Collect 20min duodenal juice as the basic secretion. Normal value
The pancreatic juice outflow is 70-230 ml/h.
The highest bicarbonate concentration is 70-125 mmol/L.
The amylase emission amount is 880 to 7400 U/kg body weight.Clinical significance
1, chronic pancreatitis or pancreatic cancer can be seen abnormally low, the diagnosis of acute pancreatitis is of little significance. In pancreatic cancer, the amount of pancreatic juice outflow is often reduced due to catheter compression, especially in large areas of pancreatic head cancer.
2. Pancreatic juice outflow, HCO3-concentration and amylase excretion decreased during cystic fibrosis of the pancreas.
3. The secretion capacity of patients with hemochromatosis increased significantly, but HCO3- was lower than normal.Low results may be diseases: precautions for elderly pancreatic cancer
When the general secretin stimulation test results are unclear or mildly abnormal, and clinically suspected pancreatic exocrine dysfunction, the pancreatic juice stimulation test can be done (the specific method is to increase the input amount to 4 units/kg) .Inspection process
The trypsin-secrelin test is mainly for the examination of the exocrine function of the pancreas. It is caused by the exocytosis of the pancreas and the exocrine function of the pancreas. During the test, the patient was not given magnesium sulfate, did not cause bile secretion, and injected secretin and trypsin. The former caused secretion of a large amount of pancreatic juice rich in electrolytes and HCO3-, which caused secretion of viscous pancreatic juice rich in enzymes. Then, the amount of pancreatic juice, the amount of HCO3- and the amount of enzyme (amylase, etc.) were measured to evaluate pancreatic exocrine function.
1. After 12 hours of fasting, insert the gastroduodenal double lumen tube, the distal hole is in the duodenal papilla, and the proximal hole is in the antrum of the stomach. The position of the intubation should be accurate, and the negative pressure should be used to attract the gastric juice. Collect 20min. The duodenal juice is secreted as a base.
2, intravenous injection of secretin 1 unit / kg (allergy test before injection), after the next 20min extraction of duodenal juice, a total of 4 times, determination of the total amount of pancreatic juice per sample, bicarbonate concentration and amylase content.Not suitable for the crowd
Inappropriate people: Generally there are no people who are not suitable.Adverse reactions and risks
Mucosal injury: soft movement during intubation, avoid excessive force, causing mucosal damage.