Thornell E, Nilsson B, Jansson R, Svanvik J
Department of Surgery at NAL-Trollhättan Hospital, Gothenburg, Sweden.
Eur J Surg. 1991 Feb;157(2):127-30.
In acute obstructive cholecystitis the increased intraluminal pressure in the gallbladder is reduced by nonsteroid anti-inflammatory drugs which effectively relieve biliary pain. To investigate if such drugs influence the clinical course, a double-blind study was performed in which indomethacin (suppositories 75 mg b.d.) was tested against placebo in 34 patients with acute obstructive cholecystitis. During the 3-day treatment period both the indomethacin and the placebo group improved significantly as regards pyrexia, pain, abdominal tenderness and leukocytosis. The indomethacin group showed significantly greater improvement than the placebo group in temperature, pain and white blood cell count on day 1, and significantly greater reduction of abdominal tenderness on day 2. The serum bilirubin fell significantly during the 3-day period in the indomethacin, but not the placebo group. The hospital stay in cases without early surgery was significantly shorter in the indomethacin group (5.4 vs. 8.5 days). Because of its favourable effect on the clinical course of acute cholecystitis, rectally administered indomethacin is useful for patients awaiting operation or scheduled for later elective surgery.
在急性梗阻性胆囊炎中，非甾体类抗炎药可降低胆囊内升高的腔内压力，有效缓解胆绞痛。为研究此类药物是否会影响临床病程，进行了一项双盲研究，在34例急性梗阻性胆囊炎患者中，将吲哚美辛（栓剂，75毫克，每日两次）与安慰剂进行对比试验。在为期3天的治疗期间，吲哚美辛组和安慰剂组在发热、疼痛、腹部压痛和白细胞增多症方面均有显著改善。吲哚美辛组在第1天的体温、疼痛和白细胞计数方面的改善明显优于安慰剂组，在第2天腹部压痛的减轻也明显大于安慰剂组。在3天期间，吲哚美辛组的血清胆红素显著下降，而安慰剂组则无此变化。在未早期手术的病例中，吲哚美辛组的住院时间明显较短（5.4天对8.5天）。由于其对急性胆囊炎临床病程有良好影响，直肠给药的吲哚美辛对等待手术或计划择期手术的患者有用。
