卡前列甲酯栓直肠给药致严重腹泻伴腹痛

Severe diarrhea with abdominal pain caused by rectal administration of carboprost methylate suppositories

1例29岁女性患者因产后子宫复旧不全，给予缩宫素注射液10 U宫颈注射、2次/d。治疗第4天，因缩宫素注射液疗效不佳，给患者直肠内置入卡前列甲酯栓1枚（0.5 mg）。直肠用药后约20 min，患者出现腹泻，70 min内排水样便4次。用药后约2 h出现持续性腹部绞痛并逐渐加重。给予甲氧氯普胺10 mg、哌替啶100 mg肌内注射，患者腹痛无明显缓解。急诊腹部超声检查未见异常。考虑腹泻、腹痛与卡前列甲酯有关。继续给予解痉、止泻、补钾、补液对症支持治疗，5 d后患者腹泻、腹痛消失。

A 29-year-old female patient received cervical injection of oxytocin injection 10 U twice daily because of postpartum subinvolution of uterus. On the 4th day of treatment, the patient received a transrectal administration of carboprost methylate suppositories 0.5 mg due to poor efficacy of oxytocin injection. About 20 minutes after rectal medication, the patient developed diarrhea with watery stools 4 times within 70 minutes. About 2 hours after rectal medication, the patient developed persistent abdominal colic and gradually aggravated. Intramuscular injections of metoclopramide 10 mg and pethidine 100 mg were given. However, her abdominal pain did not improve obviously and abdominal ultrasound examination showed no abnormality. Her diarrhea and abdominal pain were considered to be related to carboprost methylate. Symptomatic supportive treatments with spasmolysis, antidiarrheal, potassium supplementation, fluid replacement were given continuously. Five days later, diarrhea and abdominal pain disappeared.