阿片类药物在胃肠道梗阻和穿孔中的作用：一项回顾性研究。

Role of opioid use in gastrointestinal obstruction and perforation: A retrospective review.

机构信息

Consultant Psychiatrist, Sardar Patel Medical College, Bikaner, India. ORCID: https://orcid.org/0000-0001-5478-729X.

Rajasthan University of Health Sciences, Jaipur, India.

出版信息

J Opioid Manag. 2024 Jan-Feb;20(1):57-61. doi: 10.5055/jom.0850.

DOI:10.5055/jom.0850

PMID:38533716

Abstract

INTRODUCTION

Pain is one of the most common complaints that brings a patient to a hospital. For this, usually, the patient might have already consumed various types of pain killer combinations, either prescribed or over-the-counter. In some of these cases, a patient consumes these medicines unmonitored for a long time and then comes with complications, among which gastrointestinal tract obstruction and perforation are the most life threatening.

MATERIALS AND METHODS

Case files from the Department of Surgery were retrieved and studied. Patients were contacted telephonically for details of drug abuse history. These were then further studied in detail.

RESULTS

Forty-eight (68 percent) patients out of a total of 78 had a history of drug abuse. The most commonly abused pain killer was a combination of anti-inflammatory and other salts, which was found in 22 (46 percent) patients, followed by tramadol, NSAIDs, opium, and alcohol (23, 17, 10, and 4 percent, respectively). These groups were comparable in socio-demographic details except in the mean age, occupation, and gender distribution, and the difference was significant (p < 0.01). The most common cause for starting to use any of the above-mentioned pain killer was persistent pain. The most common site of obstruction in drug abusers was the stomach (60 percent), followed by the small intestine (38 percent) and the large intestine (2 percent).

LIMITATIONS

(1) This is an observational retrospective record review. (2) Records were studied in hospital settings, so results should be generalized cautiously. (3) Risk of recall bias is present.

CONCLUSION

Pain killers should always be prescribed with caution and for a short duration. Alternative options for pain relief should be made available, and doctors should be trained. Drug abusers tend to have a gastrointestinal complication at an early age, which means they are prone to further complications and recurrence if the problem is not addressed on time.

摘要

简介

疼痛是患者前往医院就诊最常见的症状之一。为此，患者可能已经服用了各种类型的止痛药物组合，无论是处方还是非处方药物。在某些情况下，患者会在无人监管的情况下长期服用这些药物，然后出现并发症，其中胃肠道梗阻和穿孔是最具威胁生命的。

材料与方法

从外科部门检索并研究了病例档案。通过电话联系患者以获取药物滥用史的详细信息。然后进一步进行详细研究。

结果

在总共 78 名患者中，有 48 名（68%）有药物滥用史。最常被滥用的止痛药是一种抗炎药和其他盐类的组合，在 22 名（46%）患者中发现，其次是曲马多、非甾体抗炎药、鸦片和酒精（分别为 23%、17%、10%和 4%）。这些组在社会人口统计学细节方面相似，除了平均年龄、职业和性别分布，差异具有统计学意义（p < 0.01）。开始使用上述任何一种止痛药的最常见原因是持续疼痛。药物滥用者中梗阻最常见的部位是胃（60%），其次是小肠（38%）和大肠（2%）。