Clinical Trans Gastroenterology : 急诊科医师使用氟哌啶醇治疗胃肠道症状的效果分析

2021-06-08 MedSci原创 MedSci原创

在美国,腹痛是患者急诊就诊的最主要原因,其次是恶心/呕吐。在急诊科,临床医生已经使用了多种疗法来治疗患者的恶心和呕吐,尤其是胃轻瘫引起的恶心和呕吐等症状。

      在美国,腹痛是患者急诊就诊的最主要原因,其次是恶心/呕吐。在急诊科,临床医生已经使用了多种疗法来治疗患者的恶心和呕吐,尤其是胃轻瘫引起的恶心和呕吐等症状,包括胃复安、昂丹司琼、劳拉西泮,以及最近的氟哌啶醇(HL)药物。

 

      HL是一种多巴胺拮抗剂。它属于第一代抗精神病药,原本用于治疗精神分裂症和相关疾病,HL还可作用于胃和脑的化学感受器触发区,减少恶心和呕吐的发生。HL 还被证明对周期性呕吐综合征 (CVS) 和大麻素剧吐综合征 (CHS) 具有治疗效果。急诊室中使用 HL还可以减少吗啡镇痛药的使用,并减少胃轻瘫急性加重患者的住院率。因此,本项研究旨在对就诊于急诊科的出现胃肠 (GI) 症状(恶心、呕吐和腹痛)而接受 HL 的患者临床改善的结果和预测因素进行探究。

 

      研究人员回顾性分析了在 2016 年 8 月至 2019 年 3 月期间就诊于急诊室的患者记录,所有患者均有胃肠道症状并接受了 HL治疗。研究结果显示总共有 281 名患者出现胃肠道症状并接受 HL 治疗:66% 为女性,32% 患有糖尿病,68% 使用过大麻,27% 使用慢性阿片类药物。所有患者均接受 HL 1.1 ± 0.3 次治疗,剂量为 2.5 ± 3.0 mg,主要使用方式是静脉注射(84.6%)。总住院时间为 7.5 ± 3.9 小时(HL 前 3.2 ± 2.1 小时,HL 后 4.4 ± 3.4 小时)。大约 4.4% 的患者出现了 HL 的副作用,其中 2 名患者出现肌张力障碍,但患者在出院前通过药物治疗得到改善。大多数患者 (56.6%) 出院回家,而 43.2% 住院主要是因为顽固性恶心或呕吐 (70.1%)。糖尿病、大麻素使用、焦虑、男性和延长 ED 住院时间与住院人数增加有关,与HL的使用无关。

图:对于延长住院时间的危险因素展示

 

      本项研究证实大多数在急诊科因胃肠道症状(尤其是恶心、呕吐和/或腹痛)就诊而接受 HL 治疗的患者均成功治疗并出院回家。HL 的使用相对安全,还可以降低再住院几率。

 

 

原始出处:

Shahsavari, Dariush. Et al. Haloperidol Use in the Emergency Department for Gastrointestinal Symptoms: Nausea, Vomiting, and Abdominal Pain. Clinical and Translational Gastroenterology.2021.

 

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    2021-07-11 bsmagic9140
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13:06:27 CST 2021, time=2021-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508446, encodeId=a6e1150844603, content=<a href='/topic/show?id=a4c96391448' target=_blank style='color:#2F92EE;'>#氟哌啶醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63914, encryptionId=a4c96391448, topicName=氟哌啶醇)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14ae9959934, createdName=venlin, createdTime=Thu Jun 10 13:06:27 CST 2021, time=2021-06-10, status=1, ipAttribution=)]
  5. 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13:06:27 CST 2021, time=2021-06-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1508446, encodeId=a6e1150844603, content=<a href='/topic/show?id=a4c96391448' target=_blank style='color:#2F92EE;'>#氟哌啶醇#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63914, encryptionId=a4c96391448, topicName=氟哌啶醇)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=14ae9959934, createdName=venlin, createdTime=Thu Jun 10 13:06:27 CST 2021, time=2021-06-10, status=1, ipAttribution=)]
    2021-11-09 许安
  6. 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  7. 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    2021-06-10 zll0628
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NEJM:氟哌啶醇和齐拉西酮治疗重症患者谵妄症毫无建树

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