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我院曾因1例急性胆囊炎伴急性坏死性胰腺炎患者手术后应用善得定(Sandostatin)治疗而诱发心绞痛急性发作。现报道如下: 患者男,54岁。因急性胆囊炎伴急性坏死性胰腺炎入院手术治疗,手术前后查心电图均正常。手术顺利,术后为了减少胰液分泌及手术创面渗血,给以善得定(瑞士Sandoz药厂生产)100μg加入10％葡萄糖溶液250ml中静脉滴注,每6小时1次,首次给药后约0.5小时,患者自诉胸闷、胸痛,面色苍白,出冷汗。血压18/12kPa,心率102次/min,心律齐、心音低、心脏无杂音,心电图记录:V_3～V_5导联ST段压低0.07～0.1mv,考虑急性心绞痛发作,立即舌下含服消心痛、吸氧、静脉滴入硝酸甘油等紧急处理后,症状改善。6小时后第2次给以善得定治疗,当250ml溶液滴入约150ml时,患者再次出现胸闷、胸痛及濒死感,当即考虑由善得定治疗而诱发心绞痛再次发作,立即停止输液,舌下含服消心痛,吸氧及对症治疗后,心绞痛症状得以控制。此后未再应用善得定,心绞痛亦未再复发,复查心电图,原V_3～V_5导联压低的ST段亦恢复至等电位线,痊愈出院。
Acute cholecystitis associated with acute necrotizing pancreatitis in our hospital was caused by the application of Sandostatin after surgery to induce acute attacks of angina. Reported as follows now: Patient male, 54 years old. Acute cholecystitis with acute necrotizing pancreatitis admitted to hospital for surgery, check before and after surgery ECG are normal. The operation was successful. In order to reduce the secretion of pancreatic juice and the bleeding on the wounds after surgery, 100 μg of Sertraline (manufactured by Sandoz Pharmaceutical Factory, Switzerland) was added to 250 ml of 10% dextrose solution intravenously once every 6 hours after the first administration 0.5 hours, the patient sued chest tightness, chest pain, pale, a cold sweat. Blood pressure 18 / 12kPa, heart rate 102 beats / min, heart rate Qi, low heart sounds, no heart noise, ECG records: V_3 ~ V_5 lead ST segment depression 0.07 ~ 0.1mv, consider acute angina attacks, Oxygen, intravenous nitroglycerin and other emergency treatment, the symptoms improved. 6 hours after the second to give good treatment, when the 250ml solution dropped to about 150ml, the patient again appear chest tightness, chest pain and sense of nearness, immediately consider the treatment of Sedum induced angina attacks again, immediately stop infusion, Sublingual oral anti-heartache, oxygen and symptomatic treatment, angina pectoris can be controlled. Since then there is no application of good set, angina no recurrence, review of ECG, the original V_3 ~ V_5 leads down the ST segment also returned to the equipotential line, discharged.