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目的探讨序贯疗法治疗肥厚性幽门狭窄(HPS)的临床疗效及安全性。方法选取2010年1月至2013年6月本院儿外科收治的先接受静脉注射后接受口服阿托品序贯给药治疗的HPS患儿,观察阿托品序贯疗法的临床疗效和不良反应。结果 26例HPS患儿中23例呕吐缓解并完成阿托品序贯疗法治疗,呕吐缓解率88.5%(23/26);2例中途放弃药物治疗,1例药物无效,3例均转手术治疗。阿托品序贯疗法治疗期间无明显药物不良反应。治疗前患儿超声检查幽门肌层厚度3.5~6.2 mm,平均(4.8±0.3)mm;治疗结束后6~8个月,超声检查幽门肌层厚1.4~2.1 mm,平均(1.8±0.2)mm。结论阿托品序贯疗法治疗HPS疗效高,安全无创,但少数患儿仍需要手术治疗。
Objective To investigate the clinical efficacy and safety of sequential therapy in the treatment of hypertrophic pyloric stenosis (HPS). Methods From January 2010 to June 2013, HPS infants who were treated with oral atropine and received sequential intravenous injection of atropine were enrolled in this hospital. The clinical efficacy and adverse reactions of atropine sequential therapy were observed. Results Twenty-three of 26 HPS patients were relieved of vomiting and were treated with sequential atropine treatment. The rate of vomiting was 88.5% (23/26). Two patients discontinued medication, one was ineffective, and the other three were treated by surgery. Atropine sequential therapy no significant adverse drug reactions during treatment. The thickness of pyloric myometrium was 3.5 ~ 6.2 mm (4.8 ± 0.3) mm after ultrasound examination. The thickness of pyloric myometrium was 1.4 ~ 2.1 mm (mean 1.8 ± 0.2 mm) at 6 ~ 8 months after the end of treatment . Conclusions Atropine sequential therapy for HPS has high curative effect and safe noninvasive operation. However, a small number of children still need surgical treatment.