胆道功能障碍合并奥奇氏括约肌痉挛患者的治疗特点

S. Shelukhina, A. S. Vasilevskaya, E. V. Markova, M. A. Butov, O. Maslova, I. A. Zagravskaya
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摘要

目的是评估胆道功能障碍、十二指肠高血压的临床表现。分析不同药理组药物对胆囊运动功能影响的数据。我们对 60 名患者(18-50 岁,平均年龄(41±4.6)岁)进行了检查,其中大部分为女性(44 名)。所有患者均接受了一般临床检查,包括血液和尿液检查、血液生化指标、腹部器官超声波检查和胆囊收缩力监测、食管胃十二指肠镜检查。受检患者分为两组,每组 30 人。使用利胆药治疗奥奇括约肌痉挛和十二指肠高血压症状并不总是合理的。治疗这类胆道功能障碍的主要药物是解痉剂,它能消除括约肌区的痉挛,恢复胆汁通过胆道的能力,减少胆道功能不全的现象。盐酸甲贝维林还能消除十二指肠高血压现象,促进胆汁从胆道排出。如果使用利胆药治疗胆道功能障碍并伴有奥狄氏括约肌痉挛的患者,病程很可能会恶化。
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Features of the management of patients with biliary dysfunctions with spasm of the sphincter of Oddi
The aim. Assessment of clinical manifestations of biliary dysfunction, duodenal hypertension. The analysis of data on the effect of drugs of various pharmacological groups on the motor function of the gallbladder is carried out.Materials and methods. We were examined 60 patients (18–50 years old, mean age 41±4.6 years), mostly women (44). All patients underwent a general clinical examination, including blood and urine tests, biochemical blood parameters, ultrasound examination of the abdominal organs and monitoring of gallbladder contractility, esophagogastroduodenoscopy. The examined patients were divided into 2 groups of 30 patients.Results and conclusion. The use of choleretics for spasm of the sphincter of Oddi and symptoms of duodenal hypertension is not always justified. The leading link in the treatment of this type of biliary dysfunction are antispasmodics, which eliminate spasm of the sphincter zones, which restores the passage of bile through the biliary tract and reduces the phenomena of biliary insufficiency. Mebeverine hydrochloride also eliminates the phenomena of duodenal hypertension, which facilitates the removal of bile from the biliary tract. When choleretics are prescribed for the treatment of patients with biliary dysfunction with spasm of the sphincter of Oddi, it is quite possible that the course of this pathology will worsen.
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