抗精神病药物引起女性精神分裂症患者麻痹性肠梗阻的回顾性分析

目的：探讨抗精神病药物引起女性精神分裂症患者发生麻痹性肠梗阻的临床特点及治疗。方法：采用回顾性研究方法,对2010年1月—3月本院9例发生麻痹性肠梗阻的住院女性精神分裂症患者的临床资料进行分析,麻痹性肠梗阻均经立位腹部X平片确诊。结果：2例在麻痹性肠梗阻前2~3 d未排便（其中1人在腹部检查中观察到肛门排气）,另2例在麻痹性肠梗阻前腹泻1~2 d,其余5例均在麻痹性肠梗阻发生的当日或前1日排便。发生麻痹性肠梗阻时,9例均出现呕吐,其中的6例伴有腹痛,另3例伴有腹胀。9例压痛均不明显,7例腹部叩诊呈鼓音,6例肠鸣音减弱或消失。通过禁食、胃肠减压及应用抗生素等治疗,9例精神分裂症患者麻痹性肠梗阻均治愈。结论：抗精神病药物致女性精神分裂症患者发生麻痹性肠梗阻的症状中,以呕吐为典型症状,多数伴有腹痛,部分有腹胀;在体征中腹部压痛不明显。保守疗法可取得较好疗效。

Retrospective study on paralytic intestinal obstruction cansed by antipsychotic drugs in female schizophrenia

Objective：To investigate the clinical features and medical treatment of paralytic intestinal obstruction caused by antipsychotics in female patients with schizophrenia.Methods：The clinical data of 9 schizophrenic cases complicated with intestinal obstruction for 3 months（from Jan to Mar in 2010） from our hospital were retrospectively analyzed.Paralytic intestinal obstruction was diagnosed by plain x-rays of the abdomen erect.Results：No feces had not been found in 2 subjects 2~3 days before paralytic intestinal obstruction occurred.Of two cases,one could be observed anal exsufflation.Diarrhea had been observed in another 2 cases 1~2 days before paralytic intestinal obstruction.Defecation could be observed the same day as or one day before paralytic intestinal obstruction in the other 5 cases.During paralytic intestinal obstruction,vomiting was observed in 9 cases,among which acute pain abdomen in 6 cases and abdominal distention in 3 cases.Less abdominal pain was found in 9 cases,with dull sound on percussion in 9 cases and diminished or absent bowel sound in 6 cases.A satisfactory result was obtained in 9 cases with a conservative treatment（fasting,gastrointestinal decompression,antibiotic treatment and etc）.Conclusion： Vomiting was the most typical symptom of paralytic intestinal obstruction caused by antipsychotic drugs in schizophrenia,with acute pain abdomen in the majority and abdominal distention in part.There were no obvious pain signs in these special patients.Conservative treatment possesses a good curative effect for paralytic intestinal obstruction with schizophrenia.