胆囊切除术后患者采用米曲菌胰酶片联合匹维溴铵治疗胆道Ⅲ型胆胰壶腹括约肌功能障碍的临床分析

Clinical analysis of patients treated with pinaverium bromide and Oryz-Aspergillus Enzyme and Pancreatin Tablet in treatment of biliary type Ⅲ Oddi sphincter dysfunction after cholecystectomy

[目的]探讨胆囊切除术后患者采用米曲菌胰酶片联合匹维溴铵治疗胆道Ⅲ型胆胰壶腹括约肌功能障碍的有效性及安全性。[方法]筛选2015年6月~2017年3月我院普外科收治的胆囊切除术后引起的胆道Ⅲ型胆胰壶腹括约肌障碍患者80例,将入选患者分为2组,治疗组40例采用基础治疗(抑酸护胃等)+匹维溴铵片+米曲菌胰酶片,对照组40例采用基础治疗+匹维溴铵片。2组患者治疗3个月后研究分析2组患者治疗前后腹痛、腹胀程度及胆总管直径的变化,对比2组治疗效果及不良反应情况。[结果]治疗3个月后2组腹痛、腹胀评分及胆总管直径较治疗前均显著降低,治疗组腹痛评分、腹胀评分及胆总管直径显著低于对照组,差异有统计学意义(P<0.05或P<0.01);且治疗组总有效37例、总有效率92.5%分别显著高于对照组28例、总有效率70.00%,差异有统计学意义(P<0.05);2组患者出现不良反应率分别为7.50%、2.50%,差异无统计学意义(P>0.05)。[结论]采用米曲菌胰酶片联合匹维溴铵治疗胆道Ⅲ型胆胰壶腹括约肌功能障碍在减轻患者腹痛、腹胀程度及缩小胆总管直径方面疗效明确,且不良反应少,值得临床推广。

[Objective]To study the efficacy and safety of cholecystectomy in patients after application of pinaverium bromide and Oryz-Aspergillus Enzyme and Pancreatin Tablet treatment of biliary type III bili- ary pancreatic ampullary sphincter dysfunction. I-Methods]80 cases of biliary sphincter dysfunction caused by cholecysteetomy in the Department of general surgery of our hospital from June 2015 to June 2017 were screened. The patients were divided into two groups. The treatment group of 40 cases by basic treatment （acid stomach protective）, pinaverium bromide Tablets, oryz-Aspergillus enzyme and pancreatin Tablet. However, the control group of 40 patients with basic treatment methods and pinaverium bromide Tablets. After 3 months of treatment,abdominal pain,bloating degree and changes in common bile duct di- ameter, compared the two groups of treatment and adverse reactions in patients before and after treatment in two groups were analyzed. [Results] After 3 months of treatment, abdominal pain score, abdominal dis- tension score and bile duct diameter of two groups were significantly decreased, and the abdominal pain score,abdominal distension score and the diameter of the common bile duct in the treatment group was sig-nificantly lower than the control group,and the difference was statistically significant（P〈0.05 or P〈0.01）. The treatment group total effective of 37 cases,the total efficiency was 92.5%,which were higher than that of the control group（28 cases,the total efficiency was 70%）,and there was a statistically signifi- cant difference（P〈0.05）. The adverse reaction rates of two group were 7.50% and 2.50%,respectively （P〉0.05）. [Conelusion]Application of pinaverium bromide and Oryz-Aspergillus Enzyme and Pancreatin Tablet treatment of biliary type III biliary pancreatic ampullary sphincter may significantly reduce abdomi- nal pain,abdominal distension, the diameter of the common bile duct and the occurrence of adverse reac- tions, which is worthy of clinical promotion.