吲哚美辛治疗脾切除术后脾热

Indometacin in treatment of postsplenectomy fever

目的：观察吲哚美辛治疗脾切除术后脾热的疗效。方法：门静脉高压症行脾切除及门奇断流术后常规应用头孢唑林、阿米卡星、西咪替丁、呋塞米、人血清蛋白等对症治疗。手术后１ ｗｋ 以上仍出现脾热的病人共６２ 例。３２ 例（ 男性１９ 例，女性１３例，年龄４１ ａ ±ｓ １０ ａ） 给予吲哚美辛２５ ｍｇ，餐后ｐｏ，ｔｉｄ。另３０ 例（ 男性１８ 例，女性１２ 例，年龄４０ ａ±１２ ａ ） ，给予地塞米松１０ ｍｇ ，溶于５ ％ 葡萄糖注射液５００ ｍ Ｌ，ｉｖ，ｄｒｉｐ ，ｑｄ，均连用５ ～７ ｄ 。结果：吲哚美辛组和地塞米松组，停药后显效率分别为９７ ％ 和５０ ％ ，（ Ｐ＜ ０ ．０１） 。结论：吲哚美辛是治疗脾切除术后脾热有效的首选药物。

AIM: To observe the effects of indometacin in the treament of postsplenectomy fever. METHODS: Sixty_two portal hypertension patients, who still had fever in spite of treament with cefazolin,amikacin, cimetidine, furosemide and human albumin for more than 1wk after splenectomy and portaazgous disconnection,were randomly divided into 2 groups in singleblind control trial: 32 patients(M 19, F 13, age 41 a±s 10 a) in treatment group received indometacin 25 mg, po, pc, tid for 5～7 d; 30 patients(M 18,F 12, age 40 a±12 a) as control received dexamethasone 10 mg dissolving in 5 % glucose injection 500 mL, iv, drip, qd for 5～7 d.RESULTS: The excellent response rate was 97 % (31/32) in indometacin group and 50 % (15/30) in dexamethasone group, (P<0.01). CONCLUSION: The therapeutic effect of indometacin was better than that of dexamethasone. Indometacin is the first_line effective drug in the treatment of postsplenectomy fever.