[Correction of duodenal motility in acute pancreatitis].
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Biomedical subjects
Publications and source records attributed to V S Kurko.
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The effect of sonic waves on motor activity of the stomach, duodenum, extrahepatic bile ducts in 152 patients at the early postoperative period was studied. Motor activity was assessed on the basis of findings of clinical investigations, electrogastroenterography, balloon tensiomanometry, cholangiodebitomanometry. It was established that influencing with the sonic waves with a frequency of 2.5 kHz, intensity of 0.66 W/cm2 2 times a day for 10-15 min within 1-3 days contributed to rapid stable restoration of motor activity of the upper alimentary canal in 86.6% of the patients.
A comparative analysis of the efficiency of sound waves, medicamentous therapy and electrostimulation upon the motor activity of the stomach, duodenum, extrahepatic bile ducts in 45 patients with diffuse peritonitis has been made. Excellent and good results were obtained in 80% of the patients treated by sound waves in complex therapy versus 66.6% obtained due to medicamentous therapy and electrostimulation. Advantages of the sonication were noted in obtaining rapid and persistent effects, absence of side effects and less amount of complications.
An analysis was carried out of the efficiency of using sound waves, drugs and electrostimulation on the motor activity of the duodenum in 45 patients with chronic duodenal obstruction of functional genesis. Excellent and good results were obtained in 80% of patients treated with sound waves complexly with other methods, in 40% when only drugs were used and 53% when only electric stimulation was used. The advantages of sound in the treatment are emphasized as concerns early effect, long-term results, absence of side-effects, low incidence of recurrences of the disease.
A comparative analysis is presented of the effect of sonic waves and drug treatment of 31 patients with postvagotomy gastrostasis. The motor gastric activity was evaluated by clinical data and electrogastrography. It was established that the effect of sonic waves (frequency: 2.5 kHz, sound stream intensity 0.66 Wt/cm2 2 times daily per 10-15 min. for 3-10 days) favour rapid restoration of the motor activity of stomach and intestines and are a favourable background for the reduced probability of development of pulmonary and cardio-vascular complications that facilitates the postoperative period in this category of patients.
The study was made of sound waves effect on duodenal motility (DM) in 60 chronic sufferers with duodenal functional ileus. The exposure to 2.0-3.0 kHz sound waves of 0.57-0.73 W/cm2 intensity promoted intestinal contractions, duodenal passage of barium, enhanced biopotential, amplitude and tone. These parameters tended to acquire values similar to duodenal motility in health.
The authors studied the effect of sonic waves on the motility of extrahepatic biliary tract and duodenum in 32 patients with hypotensive, hypokinetic dyskinesias. It was found that application of sound (the parameters are described in detail) on the region of the duodenum increased the frequency of contractions, medium biopotential, amplitude and tone of this organ to practically normal levels, resulted in normalization of the motility of extrahepatic biliary tract, favours decompression of the bile-excretory system.
In the chronic experiment it was established, that influencing of the acoustic waves with the frequency of 0.2-0.3 kHz, intensity of 0.24-0.28 W/cm2 for 10-15 minutes causes the suppression of the motor duodenal activity; with the frequency of 2.0-3.0 kHz, intensity of 0.57-0.73 W/cm2 for 10-15 min--its stimulation. It is expedient to use the acoustic waves in the parameters mentioned for correction of hypo- and hyper-motor states of the duodenum.
Disorders of the motor activity of the duodenum after surgical interventions on organs of the hepatopancreaticoduodenal zone resulted in the development of cholangitis and pancreatitis. Sonic stimulation favoured increases of the duodenal motor activity and proved to be good prophylaxis of postoperative cholangitis and pancreatitis as well as a method of treatment of these complications.
In the chronic experiments on 20 dogs, it was established that influencing by the acoustic waves with the frequency by the acoustic waves with the frequency of 0.2-0.3 kHz, intensity of 0.24-0.28 W/cm2 for 10-15 min upon the duodenal region led to decrease in the motor activity of the gastric body, antrum, duodenum, jejunum, gallbladder. Influencing by the acoustic waves with the frequency of 2.0-3.0 kHz, intensity of 0.57-0.73 W/cm2 for 10-15 min upon the duodenal region led to increase in the motor activity of the pylorus, duodenum, jejunum, gallbladder, and depression of motility of the gastric body.
The comparative assessment of the clinico-economical efficiency of the conservative and surgical treatment of the patients with duodenal ulcer disease was carried out. Direct expenses for surgical treatment were 2.5-fold higher than those for conservative treatment. For the five-year period, the expenses for the treatment of recurrences after the use of a conservative method exceeded 2.5-fold those for primary treatment and 4.5-fold--for the late treatment of patients after the operation.
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