儿童头孢曲松钠相关性假性胆囊结石的初步临床观察

The Early Clinical Analysis of Ceftriaxone-associated Biliary Pseudolithiasis in Children

目的观察应用头孢曲松钠治疗后所致假性胆囊结石的发病情况、临床特点及转归。方法对47例应用头孢曲松钠治疗患儿应用腹部B超定期观察胆囊胆泥或结石情况并记录应用过程中的伴随症状。结果发现形成胆囊假性结石22例（46.8%）,其中原发病为肺炎者2例,发生率为10.5%,原发病为胆囊炎者20例,发生率达71.4%,（χ^2=16.862P〈0.01）。胆石均发生于应用后1～7天,均伴有呕吐1～5次,其中16例伴有上腹痛,22例胆囊结石中21例于停药后1～2周消失,1例于停药8周后消失。结论头孢曲松钠可引起假性胆囊结石,且原发病为胆囊炎者发生率明显高于肺炎病例,停药后均能自行消失,无需手术治疗。

Objective To prospectively evaluate the incidence and outcome of biliary sludge and pseudolithiasis in children treated with ceftriaxone. Methods Ceftriaxone was administered intravenously at a dosage of 70～100mg·kg^-1·d^-1 to 47 children for severe infection. The ultrasonographic evaluations were performed prior to and on the 3, 7 days and the patients who had biliary sludge or pseudolithiasis were followed up with ultrasonographic evaluation periodicallyuntil these pathological phenomena disappeared weekly. Results 22 children developed pseudolithiasis and sludge in the gallbladder. The incidence in the patients with cholecystitis（71.4%） was significantly different between the incidence in the patients with pneumonia（10. 5%） （x^2= 16.862 P〈0. 01）. Conciusion The incidence of Ceftriaxone-associated biliary pseudolithiasis in the patients with cholecystitis is higher than the patients with other disease , but can rapidly reverse after cessation of therapy.