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急性结肠假性梗阻(ACPO)的发病机理不明,80％以上是其他临床疾病的并发症。小规模研究提示新斯的明对部分ACPO治疗有效。此研究目的为检验新斯的明对多种病因引起的ACPO患者是否有治疗作用。 病人和方法:自1995年1月至1998年4月,根据临床症状、体征和大肠梗阻的X线表现诊断ACPO 28例患者进入研究。剔除机械性梗阻、腹膜炎、腹腔游离气体和憩室,经水溶性对比剂灌肠和纤维乙状结肠镜检查进一步证实。首先置鼻胃管,纠正水电解质紊乱,停止使用麻醉剂和抗胆碱能药。当保守治疗无效(盲肠直径扩大至>10cm)使用新斯的明,但对使用β-阻滞剂、酸中毒和新近心肌梗塞患者禁止使用。所有患者用新斯的明2.5mg静脉推注,3分钟推完,同时监测心电图、血压、氧饱和度20分钟以上,如出现严重心动过缓(心率<50次/
The pathogenesis of acute colonic pseudoobstruction (ACPO) is unknown, with over 80% of complications of other clinical conditions. Small-scale studies suggest that neostigmine is effective for some ACPO treatments. The aim of this study was to examine whether neostigmine has a therapeutic effect on patients with ACPO induced by various causes. PATIENTS AND METHODS: From January 1995 to April 1998, 28 patients with ACPO were diagnosed on the basis of clinical manifestations, signs and signs of bowel obstruction. Excluding mechanical obstruction, peritonitis, peritoneal free gas and diverticulum, further confirmed by water-soluble contrast agent enema and sigmoidoscopy. First set nasogastric tube, correct water and electrolyte disorders, stop the use of anesthetics and anticholinergics. Neostigmine was used when conservative treatment was ineffective (caecum diameter expanded to> 10 cm), but was banned in patients with beta-blockers, acidosis and recent myocardial infarction. All patients with neostigmine 2.5mg intravenous bolus, push the end of 3 minutes, at the same time monitoring of ECG, blood pressure, oxygen saturation for more than 20 minutes, such as severe bradycardia (heart rate <50 beats /