机构地区:[1]Department of Hepatobiliary Surgery,Beijing Chaoyang Hospital Affiliated to Capital Medical University [2]Department of Radiology,Beijing Chaoyang Hospital Affiliated to Capital Medical University [3]Department of General Surgery,254 Hospital of PLA [4]Department of General Surgery,Chaoyang Central Hospital [5]Department of General Surgery,Zhanhua People’s Hospital
出 处:《World Journal of Gastroenterology》2013年第39期6618-6624,共7页世界胃肠病学杂志(英文版)
摘 要:AIM:To investigate the rate of spontaneous passage of single and symptomatic common bile duct(CBD)stones≤10 mm in diameter in 4 wk with or without a2-wk course of anisodamine.METHODS:A multicenter,randomized,placebocontrolled trial was undertaken.A total of 197 patients who met the inclusion criteria were enrolled.Ninetyseven patients were assigned randomly to the control group and the other 100 to the anisodamine group.The anisodamine group received intravenous infusions of anisodamine(10 mg every 8 h)for 2 wk.The control group received the same volume of 0.9%isotonic saline for 2 wk.Patients underwent imaging studies and liver-function tests every week for 4 wk.The rate of spontaneous passage of CBD stones was analyzed.RESULTS:The rate of spontaneous passage of CBD stones was significantly higher in the anisodamine group than that in the control group(47.0%vs 22.7%).Most(87.2%,41/47)stone passages in the anisodamine group occurred in the first 2 wk,and passages in the control group occurred at a comparable rate each week.Factors significantly increasing the possibility of spontaneous passage by univariate logistic regression analyses were stone diameter(<5 mm vs≥5 mm and≤10 mm)and anisodamine therapy.Multivariate logistic regression analyses revealed that these two factors were significantly associated with spontaneous passage.CONCLUSION:Two weeks of anisodamine administration can safely accelerate spontaneous passage of single and symptomatic CBD stones≤10 mm in diameter,especially for stones<5 mm.AIM: To investigate the rate of spontaneous passage of single and symptomatic common bile duct (CBD) stones ≤ 10 mm in diameter in 4 wk with or without a 2-wk course of anisodamine. METHODS: A multicenter, randomized, placebo-controlled trial was undertaken. A total of 197 patients who met the inclusion criteria were enrolled. Ninety-seven patients were assigned randomly to the control group and the other 100 to the anisodamine group. The anisodamine group received intravenous infusions of anisodamine (10 mg every 8 h) for 2 wk. The control group received the same volume of 0.9% isotonic saline for 2 wk. Patients underwent imaging studies and liver-function tests every week for 4 wk. The rate of spontaneous passage of CBD stones was analyzed. RESULTS: The rate of spontaneous passage of CBD stones was significantly higher in the anisodamine group than that in the control group (47.0% vs 22.7%). Most (87.2%, 41/47) stone passages in the anisodamine group occurred in the first 2 wk, and passages in the control group occurred at a comparable rate each week. Factors significantly increasing the possibility of spontaneous passage by univariate logistic regression analyses were stone diameter (< 5 mm vs ≥ 5 mm and ≤ 10 mm) and anisodamine therapy. Multivariate logistic regression analyses revealed that these two factors were significantly associated with spontaneous passage. CONCLUSION: Two weeks of anisodamine administration can safely accelerate spontaneous passage of single and symptomatic CBD stones ≤ 10 mm in diameter, especially for stones < 5 mm.
关 键 词:Common BILE duct STONES ANISODAMINE SPONTANEOUS PASSAGE Success rate Randomized controlled trial
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