生长抑素治疗肠梗阻的临床研究

Clinical study of somatostatin on intestinal obstruction

目的探讨生长抑素治疗肠梗阻的疗效。方法采用多中心、随机对照方法,将各种不同类型的肠梗阻162例随机分为治疗组和对照组。对照组给予常规治疗,包括禁食、胃肠减压、纠正水电解质和酸碱平衡紊乱,全胃肠外营养以及应用抗生素;治疗组在常规治疗基础上加用生长抑素(思他宁)6mg加生理盐水500ml静脉滴注,维持24h。观察和比较两组治疗前后临床症状及体征改善情况、胃肠减压量、水电解质指标的改变和中转手术率。结果治疗组临床症状明显改善;与对照组相比,腹痛和腹胀的缓解率分别为90.1%、76.5%(P<0.05);肛门恢复排气排便比率分别为88.8%、76.0%(P<0.05);胃肠减压量明显少于对照组,分别为(277±225)ml/d、(564±278)ml/d(P<0.01);中转手术率明显低于对照组,分别为8.7%、19.8%(P<0.05)。结论在常规治疗基础上,应用生长抑素治疗各种类型肠梗阻,可明显改善临床症状,提高保守治疗的成功率。

Objective To investigate the effects of somatostatin on intestinal obstruction. Methods One hundred and sixty two patients suffering from obstructive ileus were randomly divided into control group and stilamin group. Patients in the control group were treated with routine therapy including gastroenteral decompression,intravenous replacement of fluid and electrolytes,total parenteral nutrition and antibiotics. Patients in the stilamin group received continuous infusion of stilamin (6 mg/d) intravenously plus routine therapy. Results Two to seven days after treatment,the clinical symptoms were significantly improved in stilamin group,the average volume of gastroenteral decompression reduced in stilamin group compared to the control group(277±225)ml/d vs(564±278 )ml/d(P< 0.01). The rate of transferring to operation in stilamin group (8.69%) was significantly lower than that in the control group (19.8%)(P< 0.05). Conclusions Stilamin combined with routine treatment is an effective method to treat intestinal obstruction such as early postoperative inflammatory small bowel obstruction(EPISBO),adhensive bowel obstruction,pseudo colon obstruction and malignant bowel obstruction.