Añez M S, Martínez D, Pacheco J L, González H, Rivera J, Pelaschier E, Uzcátegui L, Romero M D, Molina Z, Roditti de Montilla M
Unidad de Hepatología-Gastroenterología y Nutrición, Hospital Dr. Pedro Emilio Carrillo, Valera, Venezuela.
G E N. 1991 Jan-Mar;45(1):32-7.
Prostaglandins GE2 produces on the gallbladder a rise in intraluminal pressure, an increase in in intraluminal secretion, improves gallbladder contraction and decreases its absorption capacity. In this study, patients who received indomethacin twice a day by rectum, showed a significant reduction in volume and area of gallbladder after 24 and 48 hours (P < 0.05). The gallbladder volume after 24 hours had SEM 9.13 cm3, 95% CI 55.28 + 73.49 (P < 0.05). Score pain reduction after 24 hours was also significant (P < 0.001). The patients who underwent the classical Baralcina treatment of one IV vial BID showed a reduction in diameter and area of gallbladder but this was not statistically significant (P < 0.10). Reduction of volume at 24 hours was SEM 5.34 cm3 95% CI - 64.72 + 76.60 P 0.10 NS; and at 48 hours SEM 3.5 cm3, 95% CI 59.52% + 66.52 P 0.40. Score pain reduction was only significant at 48 hours P 0.001. The number of patients without pain at 24 hours was significantly higher in the indomethacin group ESP 0.21; 95% CI 0.46 + 0.88 P 0.001. In conclusion indomethacin is a useful medication in the treatment of acute cholecystitis and biliary colic due to its anti-prostaglandin effect on the gallbladder.
前列腺素E2可使胆囊内压升高、腔内分泌增加、胆囊收缩增强并降低其吸收能力。在本研究中,每天经直肠给予两次吲哚美辛的患者,在24小时和48小时后胆囊体积和面积显著减小(P<0.05)。24小时后胆囊体积的标准误为9.13cm³,95%置信区间为55.28+73.49(P<0.05)。24小时后疼痛评分降低也很显著(P<0.001)。接受经典的Baralcina治疗(每日两次静脉注射一瓶)的患者胆囊直径和面积减小,但无统计学意义(P<0.10)。24小时时体积减小的标准误为5.34cm³,95%置信区间为-64.72+76.60,P=0.10,无显著性差异;48小时时标准误为3.5cm³,95%置信区间为59.52%+66.52,P=0.40。疼痛评分仅在48小时时显著降低(P=0.001)。吲哚美辛组24小时时无痛患者数量显著更多(ESP=0.21;95%置信区间为0.46+0.88,P=0.001)。总之,由于吲哚美辛对胆囊的抗前列腺素作用,它是治疗急性胆囊炎和胆绞痛的有效药物。