生长抑素类似物在急性机械性肠梗阻中的应用

Application of somatostatin analogues in treatment of acute obstructive ileus

目的评价生长抑素类似物对急性机械性肠梗阻的治疗作用。方法将50例连续收治的急性完全性肠梗阻患者随机分为治疗组和对照组。在常规治疗的基础上治疗组应用生长抑素类似物,对照组则给予生理盐水。观察两组用药24h后的胃肠减压量、首次用药至肛门恢复排气的时间,并比较治愈率。结果治疗组和对照组用药24h后胃肠减压量分别为(397±115)ml/d和(933±468)ml/d(P<0.01)。首次用药至肛门排气时间分别为(65±12)h和(101±26)h(P<0.01)。治愈率分别为83%(20/24)和69%(18/26)(P>0.05)。治疗组均没有肠管缺血坏死的发生,而对照组中有2例发生小肠缺血坏死。结论肠梗阻早期应用生长抑素可以显著减少患者的胃肠减压量,缩短肠梗阻的病程且不减少肠管的血运,是治疗机械性肠梗阻的一种安全、有效的保守治疗方法。

Objective To study the effect of somatostatin on acute obstructive ileus.Methods Fifty consecutive patients with total obstructive ileus were randomly divided into two groups.Apart from routine treatments,somatostatin analogue octreotide was administrated in the experimental group while normal saline in the control group.Gastrointestinal drainage after 24-hour administration of octreotide,time from first administration to anal exhaustion,and the cure rate of the two groups were compared.Results Gastrointestinal drainage after 24-hour administration of octreotide was（397±115） ml/d in the experimental group and（933±468） ml/d in the control group（P〈0.01）.The time from the first administration to exhaust of the anus was（65±12） hours and（101±26） hours,respectively（P〈0.01）.The cure rates of the two groups were 83%（20/24） and 69%（18/26）,respectively（P〉0.05）.There was no ischemia or necrosis in the experimental group,but necrosis of the intestine proximal to the area of obstruction in the control group.Conclusions Early administration of somatostatin analogue could reduce the volume of gastrointestinal drainage,decrease the course of obstructive ileus but could not cause ischemia or necrosis of the intestine.Thus it is an effective and safe adjuvant treatment for obstructive ileus.