胆囊切除术后患者胆道Ⅲ型Oddi括约肌功能障碍的治疗

摘要

Objective To study the therapeutic effect of pinaverium bromid and oryz-aspergillus enzyme and pancreatin tablet on patients with bile duct Ⅲ of sphincter of Oddi dysfunction (SOD) after cholecystectomy.Methods 72 patients who had a diagnosis consistent with bile duct Ⅲ of SOD seen from February 2010 to February 2013 in our hospital were randomly divided into the control group and the treatment group.Patients in the control group were given pinaverium bromid for 3 months while patients in the treatment group were,in addition to pinaverium bromid,given oryz-aspergillus enzyme and pancreatin tablet.Relief of abdominal pain,abdominal distention and recurrence of the above symptoms after drug withdrawal were studied.Results The scores on abdominal pain in the treatment group before and after treatment were 7.5 ± 1.1 and 3.0 ± 1.6 (P ＜ 0.05) while the scores in the control group were 7.4 ± 1.1 and 5.0 ± 1.4 (P ＜ 0.05),respectively.Alleviation of abdominal pain in the treatment group was superior to the control group (P ＜ 0.05).The scores on abdominal distention in the treatment group before and after treatment were 5.4 ± 0.6 and 1.6 ± 0.5 (P ＜ 0.05) while the scores in the control group were 5.2 ± 0.5 and 4.7 ± 0.8 (P ＞ 0.05),respectively.Alleviation of abdominal distention in the treatment group was superior to the control group (P ＜0.05).The scores of abdominal pain and distention in half year after 3 months' therapy in the treatment group were 3.1 ± 1.7 and 1.7 ± 1.1,respectively,which obviously were lower than the control group (5.4 ± 1.4 and 5.0 ± 0.6,P ＜ 0.05).Conclusions Pinaverium bromid and oryz-aspergillus enzyme and pancreatin tablet could effectively alleviate abdominal pain and distention in patients with bile duct Ⅲ of SOD after cholecystectomy and the recurrence rates of symptoms were significantly lower.%目的 观察匹维溴铵联合米曲菌胰酶片治疗胆囊切除术后患者胆道Ⅲ型Oddi括约肌功能障碍(SOD)的临床疗效.方法 将我院2010年2月至2013年2月诊治的72例胆囊切除术后符合胆道Ⅲ型SOD诊断的患者随机分为对照组和治疗组.两组患者均给予相应的对症治疗,其中对照组给予匹维溴铵,治疗组同时加用米曲菌胰酶片,疗程3个月.观察患者治疗后腹痛、腹胀缓解效应及停药后半年内腹痛、腹胀的复发状况.结果 治疗前后腹痛评分治疗组分别为7.5±1.1、3.0±1.6,对照组分别为7.4±1.1、5.0±1.4,两组患者腹痛症状均有效缓解(P＜0.05),但治疗组疗效优于对照组(P＜0.05).治疗前后腹胀评分治疗组分别为5.4±0.6、1.6±0.5,腹胀明显缓解(P＜0.05);对照组治疗前后分别为5.2±0.5、4.7±0.8,腹胀无明显缓解(P＞0.05),治疗组疗效优于对照组(P＜0.05).3个月疗程结束半年后再次进行腹痛、腹胀评分,治疗组评分(3.1±1.7、1.7±1.1)均明显低于对照组(5.4±1.4,5.0±0.6),差异有统计学意义(P＜0.05).结论 匹维溴铵联合米曲菌胰酶片可有效缓解胆囊切除术后胆道Ⅲ型SOD患者腹痛、腹胀症状,复发率较低.