Hallerbäck B, Ander S, Glise H
Scand J Gastroenterol. 1987 May;22(4):420-4. doi: 10.3109/00365528708991484.
The effect of treatment with a non-selective beta-adrenoceptor blocker (propranolol) and an acetylcholinesterase blocker (neostigmine) on the duration of postoperative ileus after cholecystectomy was investigated in a double-blind, randomized study comprising 51 patients. Propranolol (P), 10 mg intravenously twice daily was, together with neostigmine (N), 0.5 mg subcutaneously twice daily, administered to 16 patients. Eighteen patients were treated with neostigmine, 0.5 mg subcutaneously twice daily only, and 17 patients were placebo-treated controls (C). The medical treatment started in the evening of the day of operation. The time to first passage of stool after operation was determined and used as a measure of duration of the postoperative ileus. The mean time was 68 +/- 6 h in the P + N-treated group, 82 +/- 6 h in the N group, and 90 +/- 7 h in the C group. The difference between the P + N group and controls was significant (p less than 0.01). P + N was effective in patients older than 60 years (p less than 0.01), whereas no effect was seen in patients younger than 60 years. In conclusion, treatment with a combination of propranolol and neostigmine shortened the duration of postoperative paralytic ileus after cholecystectomy. This effect was not seen after treatment with neostigmine only. The effect of P + N was most marked in patients older than 60 years.
在一项纳入51例患者的双盲随机研究中，研究了非选择性β-肾上腺素能受体阻滞剂（普萘洛尔）和乙酰胆碱酯酶阻滞剂（新斯的明）对胆囊切除术后肠梗阻持续时间的影响。16例患者接受普萘洛尔（P）静脉注射，每日2次，每次10 mg，同时皮下注射新斯的明（N），每日2次，每次0.5 mg。18例患者仅接受新斯的明皮下注射，每日2次，每次0.5 mg，17例患者接受安慰剂对照治疗（C）。药物治疗在手术当天晚上开始。确定术后首次排便时间，并将其作为术后肠梗阻持续时间的衡量指标。P+N治疗组的平均时间为68±6小时，N组为82±6小时，C组为90±7小时。P+N组与对照组之间的差异具有统计学意义（p<0.01）。P+N对60岁以上患者有效（p<0.01），而对60岁以下患者无效果。总之，普萘洛尔和新斯的明联合治疗缩短了胆囊切除术后麻痹性肠梗阻的持续时间。仅用新斯的明治疗后未观察到这种效果。P+N的效果在60岁以上患者中最为明显。
