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題名 | Medical Treatment with Atropine Sulfate for Hypertrophic Pyloric Stenosis=使用阿托平以藥物方式治療肥厚性幽門狹窄 |
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作者 | 黃有志; 蘇百弘; | 書刊名 | 臺灣兒科醫學會雜誌 |
卷期 | 45:3 民93.05-06 |
頁次 | 頁136-140+188 |
分類號 | 417.5012 |
關鍵詞 | 藥物治療; 肥厚性幽門狹窄; 阿托平; Hypertrophic pyloric stenosis; Atropine; Medical treatment; |
語文 | 英文(English) |
中文摘要 | 這個研究最主要是針對使用阿托平以藥物的方式,治療肥厚性幽門狹窄,藉此以提供另一有效而非開刀的方式治療肥厚性幽門狹窄。在這份報告中共有五名病人,他們住院的主訴是有噴射狀的嘔吐。而且在腹部超音波檢查之後他們全都符合肥厚性幽門狹窄的診斷。他們症狀開始的年紀是30.8±15.5天大,住院時年紀是43.2±9.6天大。嘔吐次數一天5.8±2.3次。在住院之後,五名病人皆按照阿托平藥物治療計劃來使用阿托平。治療方式是在每4小時的餐前5分鍾先用百分之10的阿托平,以0.01mg/kg的劑量來使用。在病人沒有嘔吐的情況下,每餐以增加10cc的原則,直到足量喂食量120cc/kg/day的目標獲得達成。而靜脈方式給予阿托平,在病人一整天都沒有吐的情形下就會改以口服以0.02mg/kg/dose的方式給予。在病人達到足量喂食(120cc/kg/day)的目標二天後病人就可以出院。而在辯論口服方式的阿托平每2個星期減半一次直到幽門肌肉厚度3.5mm即停止阿托平使用。在這個研究中,五個肥厚性幽門狹窄都成功的使用了阿托平來治療肥厚性幽門狹窄。他們吐的次數一天內不大於2次達成的天數是1.8±1.3天。靜脈方式給予阿托平使用日數是(6.4±3.4天)。口服方式給予使用日數是(30±9天)。而使用阿托平的總日數是(36.4±9.58天)。他們達到足量喂食(120cc/kg/day)的目標是(8±5.3天),住院日數是(14.6±6.2天),入院時體重是(4000±760.8gm),出院體重是(4282±901gm),在阿托平使用滿一個月後體重是(5210±772gm)。而使用阿托平一個月後增加的體重爲(1262±411.4gm)。有二名病人在剛開始使用靜脈方式給予阿托平的前幾個劑量有心跳到180~200次/分鍾及臉部潮紅的情況,此外無其它併發症出現。由上的結論是以藥物方式,先以靜脈方式然後再次口服方式給予阿托平是一種有效治療肥厚性幽門狹窄的方式。而外科治療在肥厚性幽門狹窄病人身上則不是一定需要。 |
英文摘要 | We investigated whether atropine sulfate was an effective, non-surgical method for treating hypertrophic pyloric stenosis (HPS). The study group consisted of 5 patients, all of the patients presented with projectile vomiting. Hypertrophic pyloric stenosis was diagnosed based on abdominal sonographic findings. The age when symptom arose was 30.8 ±15.5 (mean ±SD) days, the age upon admission was 43.2 ±9.6 days. The frequency of vomiting was 5.8±2.3 times per day. After admission, all patients received 10% atropine sulfate 0.01 mg/kg intravenous (IV) for 5 minutes q4H (every four hours) before each feeding. Formular milk was started and increased by 10 ml every feeding until full feeding (120 mI/kg/day) was achieved. When vomiting had ceased for a period of one day, IV atropine was changed to 0.02 mg/kg oral q4H before each feeding. The patient was hospitalized until full feeding was maintained for more than 2 days. Then oral atropine was tapered by half a dose every 2 weeks. Oral atropine was continued until the thickness of the pyloric muscle had normalized (<3.5 mm). All five patients were successfully treated with atropine sulfate. The frequency of vomiting was reduced to less than two times per day (1.8±1.3 days). IV atropine was used for 6.4±3.4 days, and the oral form was used for 30±9 days. The total number of days of atropine sulfate treatment was 36.4±9.58 days. Full feeding was achieved at 8±5.3 days. The hospitalization was 14.6±6.2 days. The body weight when admitted was 4000±760.8 gm and the body weight when discharged was 4282±901 gm. The body weight one month after treatment was 5210±772.5 gm. The body weight gain one month after atropine treatment was 1262±441.4 gm. Body weigh range on admission was from<3(superscript rd) to 25(superscript th) percentile, and after one month of atropine treatment, the body weight range was from 10(superscript th) to 75(superscript th) percentile. Complications included transiently elevated heart rates (180~200 times/min) in two patients and facial flushing after the first dose of IV atropine in one patient. In conclusion, conservative treatment with initially IV atropine in the initial stages instead of oral atropine sulfate is an effective alternative to pyloromyotomy, particularly in infants with major concurrent disease or when parents are unwilling to let their infants undergo surgery. Surgical intervention is not always necessary. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。