氢溴酸山莨菪碱注射液促排小胆总管结石的临床观察

Clinical observation of Anisodamine Hydrobromide Injection on the excretion of small common bile duct stones

目的 观察氢溴酸山莨菪碱注射液对有症状的单个直径≤10 mm的胆总管(CBD)结石的促排作用.方法 回顾性分析2016年9月~2019年6月四川省人民医院新津分院普外科诊断为有症状的单个直径≤10 mm的CBD结石患者127例的结石排出情况,其中使用氢溴酸山莨菪碱注射液患者68例,将其作为试验组;未使用氢溴酸山莨菪碱注射液者59例,将其作为对照组.试验组在一般治疗基础上加用氢溴酸山莨菪碱注射液,10 mg/次,静脉注射,q6 h,连续使用12 d;对照组仅使用一般治疗.比较两组患者CBD结石排出率与不良反应.结果 试验组CBD结石6 d排出率、总排出率均高于对照组,差异有统计学意义(P<0.05或P<0.01).试验组直径<5 mm的CBD结石排出率高于对照组,差异有高度统计学意义(P<0.01);试验组直径5~10 mm的CBD结石排出率与对照组比较,差异无统计学意义(P>0.05).试验组对直径<5 mm的CBD结石的促排率高于直径5~10 mm的CBD结石,差异有高度统计学意义(P<0.01);对照组直径<5 mm的CBD结石的自排率与直径5~10 mm的CBD结石比较,差异无统计学意义(P>0.05).试验组有8例患者出现潮红、口干,余未见其他不良反应;两组患者不良反应比较,差异有统计学意义(P<0.05).结论 氢溴酸山莨菪碱注射液对有症状的单个直径≤10 mm的CBD结石有促排作用,对<5 mm的CBD结石促排尤其显著,安全性佳.

Objective To observe the effect of Anisodamine Hydrobromide Injection on the excretion of single symptomatic common bile duct(CBD)stones with diameter≤10 mm.Methods A retrospective analysis was performed on the stone discharge of 127 patients with single symptomatic CBD stones with diameter≤10 mm diagnosed in the Department of General Surgery,Xinjin Branch of the Sichuan Provincial People′s Hospital,from September 2016 to June2019.Among them,sixty-eight patients who received of Anisodamine Hydrobromide Injection were included in the experimental group.Fifty-nine patients who did not receive Anisodamine Hydrobromide Injection were treated as the control group.In the experimental group,Anisodamine Hydrobromide Injection was added on the basis of general treatment,10 mg/time,intravenous injection,q6 h,continuous use for 12 days.The control group received only general treatment.The discharge rate and adverse reactions of CBD stones in the two groups were compared.Results The discharge rate of 6 day and total discharge rate of CBD stones in the experimental group were higher than those in the control group,with statistically significant differences(P<0.05 or P<0.01).The discharge rate of CBD stones with diameter<5 mm in the experimental group was higher than that in the control group,and the difference was highly statistically significant(P<0.01).There was no statistically significant difference in the discharge rate of CBD stones with a diameter of 5-10 mm between the experimental group and the control group(P>0.05).In the experimental group,the rate of promoting the discharge of CBD stones with a diameter of<5 mm was higher than that of CBD stones with a diameter of 5-10 mm,and the difference was highly statistically significant(P<0.01).There was no significant difference in self-discharge rate between the CBD stones with a diameter of<5 mm and CBD stones with a diameter of 5-10 mm in the control group(P>0.05).In the experimental group,8 patients presented with flushing and dry mouth,but no other adverse reactions were observed.The difference of adverse reactions between the two groups was statistically significant(P<0.05).Conclusion Anisodamine Hydrobromide Injection has the effect of promoting the discharge of single symptomatic CBD stones with the diameter≤10 mm,especially for CBD stones with the diameter<5 mm,which is of good safety.