可口可乐联合胃镜下碎石治疗植物性胃石症  

Combination of oral coca-cola and endoscopic mechanical lithotripsy for gastric bezoars

作　　者：吴龙奇[1] 刘娓娓[1] 李建华[1] 邵翠青 刘雪平[1] 

机构地区：[1]山东省交通医院消化内科,山东济南250031

出　　处：《中国内镜杂志》2013年第1期26-28,共3页China Journal of Endoscopy

摘　　要：目的探讨口服可口可乐治疗植物性胃石症的疗效及治疗时机的选择。方法 62例植物性胃石症患者中,病史≤3d的39例患者随机17例仅接受常规治疗(Ⅰ组),另22例(Ⅱ组)和病史4～7d的16例(Ⅲ组)及病史>7d的7例(Ⅳ组)除常规治疗外,给予可口可乐200～300mL,每4h1次,口服3d后复查胃镜,仍有胃石者采用胃镜下机械碎石法碎石,术后继续口服可口可乐200～300mL,每4h1次,口服3～4d,再次复查胃镜观察胃石是否消失。结果Ⅱ组22例口服可口可乐患者中16例(72.7%)胃石消失,而未服用可口可乐Ⅰ组17例患者仅7例胃石消失,两者比较差异显著(P<0.05)。口服可口可乐的Ⅱ组疗效显著好于Ⅲ组(P<0.05)及Ⅳ组(P<0.01),差异有显著性。胃石未消失的32例患者均给予胃镜下碎石治疗,4d后胃镜再次复查胃石消失者28例,余4例患者行第2次胃镜下治疗后胃石消失。结论口服可口可乐治疗植物性胃石安全、痛苦少,其效果取决于治疗时机的选择:对成石时间短,病史≤3d者,可口可乐治疗效果好,可作为可供选择的治疗方法;而对于成石时间长,病史≥4d者,应首选胃镜机械碎石,破坏胃石坚硬外壳,再辅以可口可乐治疗增强疗效。【Objective】To investigate the effect of oral Coca-Cola in treating gastric bezoars and option of treatment timing. 【Methods】Sixty-two patients were diagnosed under endoscopy, upper gastrointestinal imaging or ultrasound, and then oral coca-cola 200~300 mL was given, a time every six hours. After three days of oral administration,all patients received gastroscopy. If bezoars were still existing, endoscopic mechanical lithotripsy was used and continuous oral coca-cola was prescribed. A repeated gastroscopy was performed after three-four days. All patients received conventional therapy： the first week, gave pantoprazole sodium 42.3 mg, intravenous drip, qd; then rabeprazole 20 mg, once a day in second week. Throughout the treatment period of two weeks, patients had been taking teprenone capsules 50 mg （three times daily, orally） and domperidone 10 mg （three times daily, orally）.【Results】In twenty-two cases of group Ⅱ, sixteen cases of gastric bezoars disappeared . And in group Ⅰ, only seven cases were effective in 17 patients. Compared between group Ⅱ and group Ⅰ, the difference was significant （P 0.05）. Efficacy of Group Ⅱ was also significantly better than group Ⅲ （P 0.05） and group Ⅳ （P 0.01）. For gastric bezoars still existing in thirty-two patients, we performed endoscopic mechanical lithotripsy and then gave oral cocacola for four days, twenty-eight patients were effective. 【Conclusions】The dissolution of gastric bezoars with oral coca-cola is a safe, rapid therapy. The effects of coca-cola depend on the choice of treatment timing. If the course is less than three days, oral coca-cola should be used as a kind of treatment choice. If the course is more than three days, endoscopic mechanical lithotripsy is of choice, oral administration of coca-cola can be used as adjuvant therapy to enhance the therapeutic effect.

关 键 词：植物性胃石 可口可乐 机械碎石 

分 类 号：R573.8[医药卫生—消化系统]