Clinical observation of Anisodamine Hydrobromide Injection on the excretion of small common bile duct stones
LYU Haopeng1 SONG Wenjiu1 PENG Wei2 WEN Tianfu2 LI Chuan2
1.Department of General Surgery, Xinjin Branch of the Sichuan Provincial People′s Hospital, Sichuan Province, Xinjin 611430, China;
2.Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, Sichuan Province, Chengdu 610041, China
Abstract：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 June 2019. 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, q6h, 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.
吕浩鹏1 宋文玖1 彭伟2 文天夫2 李川2. 氢溴酸山莨菪碱注射液促排小胆总管结石的临床观察[J]. 中国医药导报, 2020, 17(16): 82-85.
LYU Haopeng1 SONG Wenjiu1 PENG Wei2 WEN Tianfu2 LI Chuan2. Clinical observation of Anisodamine Hydrobromide Injection on the excretion of small common bile duct stones. 中国医药导报, 2020, 17(16): 82-85.
[1] 李军祥，陈誩，梁健.胆石症中西医结合诊疗共识意见（2017年）[J].中国中西医结合消化杂志，2018，26（2）：132-138.
[2] Stinton LM，Shaffer EA. Epidemiology of gallbladder disease：cholelithiasis and cancer [J]. Gut Liver，2012，6（2）：172-187.
[3] 李强，汪志伟，柴琛.胆总管结石治疗方法的研究进展[J].胃肠病学和肝病学杂志，2017，26（12）：1436-1438.
[4] 余海波，董亚东，田广金，等.腹腔镜联合胆道镜胆总管探查术治疗复发性胆总管结石疗效观察[J].中华实用诊断与治疗杂志，2019，33（5）：458-460.
[5] 袁锡裕，瑞平，曾沛强，等.药物排石疗法治疗胆总管结石52例临床分析[J].中外医学研究，2014（2）：123-124.
[6] 张立平，赵玉清.中医药治疗胆总管结石的研究进展[J].中国医药导报，2019，16（15）：37-40.
[7] Gao J，Ding XM，Ke S，et al. Anisodamine accelerates spontaneous passage of single symptomatic bile duct stones ≤ 10 mm [J]. World J Gastroenterol，2013，19（39）： 6618-6624.
[8] 王五俊.胆总管结石的临床治疗研究进展[J].中国处方药，2019，17（5）：23-24.
[9] 龚加明.胆总管结石的微创治疗研究进展[J].微创医学，2011年，6（5）：439-441.
[10] Singh AN，Kilambi R. Single-stage laparoscopic common bile duct exploration and cholecystectomy versus two-stage endoscopic stone extraction followed by laparoscopic cholecystectomy for patients with gallbladder stones with common bile duct stones：systematic review and meta-analysis of randomized trials with trial sequential analysis [J]. Surg Endosc，2018，32（9）：3763-3776.
[11] Trindade AJ，Hirten R，Sejpal DV. Use of digital cholangioscopy in a dilated bile duct for detection of small symptomatic bile duct stones [J]. Gastrointest Endosc，2016，84（2）：372.
[12] 王宏，吴小荣，李虎山，等.胆石症患者胆道手术局部感染的危险因素[J].中华肝胆外科杂志，2016，22（5）：304-307.
[13] Doshi B，Yasuda I，Ryozawa S，et al. Current endoscopic strategies for managing large bile duct stones [J]. Dig Endosc，2018，30 Suppl 1：59-66.
[14] 何清，沈丽，尹春瑶，等.医护一体化护理在防治胆总管结石患者ERCP术后并发症中的应用效果[J].检验医学与临床，2019，16（10）：1406-1408.
[15] Tranter SE，Thompson MH. Spontaneous passage of bile duct stones：frequency of occurrence and relation to clinical presentation [J]. Ann R Coll Surg Engl，2003，85（3）：174-177.
[16] Lefemine V，Morgan RJ. Spontaneous passage of common bile duct stones in jaundiced patients [J]. Hepatobiliary Pancreat Dis Int，2011，10（2）：209-213.
[17] 张雯雯，吕少诚，史宪杰，等.单中心30年胆道外科疾病谱的变化趋势及意义[J].中华医学杂志，2016，96（24）：1912-1915.
[18] Portincasa P，Di Ciaula A，Wang HH，et al. Medicinal treatments of cholesterol gallstones： old，current and new perspectives [J]. Curr Med Chem，2009，16（12）：1531-1542.
[19] 张煜程，袁玉青，吴显光，等.区域用药对胆总管结石取石术中术后胆道压力的影响[J].中国现代医生，2018， 56（11）：88-90，94.
[20] 刘立民，张宗明，张翀，等.联合应用利胆排石药物治疗胆总管细小结石可行性分析[J].中华普通外科学文献：电子版，2019，13（3）：202-207.
[21] 孙凯，谢一凡，崔永耀，等.山莨菪碱4个异构体的分离及其抗胆碱活性比较[J].上海交通大学学报：医学版，2011，31（4）：406-410.
[22] 谢晶曦，刘春雪，贾效先，等.山莨菪碱的全合成研究[J].科学通报，1975（4）：197-198.
2020, Vol. 17 
京公网安备 11010502046598号