Kawahara H, Imura K, Nishikawa M, Yagi M, Kubota A
Division of Paediatric Surgery, Osaka Medical Centre and Research Institute for Maternal and Child Health, Osaka, Japan.
Arch Dis Child. 2002 Jul;87(1):71-4. doi: 10.1136/adc.87.1.71.
To assess the efficacy of a new regimen of intravenous atropine treatment for infantile hypertrophic pyloric stenosis (IHPS) with special reference to regression of pyloric hypertrophy.
Atropine was given intravenously at a dose of 0.01 mg/kg six times a day before feeding in 19 patients with IHPS diagnosed from radiographic and ultrasonographic findings. When vomiting ceased and the infants were able to ingest 150 ml/kg/day formula after stepwise increases in feeding volume, they were given 0.02 mg/kg atropine six times a day orally and the dose was decreased stepwise.
Of the 19 infants, 17 (89%) ceased projectile vomiting after treatment with intravenous (median seven days) and subsequent oral (median 44 days) atropine administration. The remaining two infants required surgery. No significant complications were encountered. Ultrasonography showed a significant (p < 0.05) decrease in pyloric muscle thickness, but no significant shortening of the pyloric canal after completion of the atropine treatment. The patients exhibited failure to thrive at presentation, but were thriving at 6 months of age (p < 0.01).
This atropine therapy resulted in satisfactory clinical recovery. Pyloric muscle thickness was significantly reduced.
评估一种新的静脉注射阿托品治疗婴儿肥厚性幽门狭窄（IHPS）方案的疗效，特别关注幽门肥厚的消退情况。
对19例经影像学和超声检查确诊为IHPS的患儿，在喂奶前静脉注射剂量为0.01mg/kg的阿托品，每日6次。当呕吐停止且患儿在逐步增加奶量后能够摄入150ml/kg/天的配方奶时，给予0.02mg/kg阿托品口服，每日6次，剂量逐步减少。
19例婴儿中，17例（89%）在接受静脉注射（中位时间7天）及随后口服（中位时间44天）阿托品治疗后停止喷射性呕吐。其余2例婴儿需要手术治疗。未出现明显并发症。超声检查显示阿托品治疗结束后幽门肌厚度显著降低（p<0.05），但幽门管无明显缩短。患儿就诊时生长发育迟缓，但6个月大时发育良好（p<0.01）。
这种阿托品治疗导致了满意的临床恢复。幽门肌厚度显著降低。
