肠梗阻非手术治疗中早期应用生长抑素的临床观察

Early application of somatostatin in non-surgical treatment of intestinal obstruction

目的探讨生长抑素(思他宁)在粘连性肠梗阻非手术早期治疗中的作用。方法将收治的131例不同类型的粘连性肠梗阻患者分为思他宁治疗组(71例)和常规治疗对照组(60例)。治疗组入院后除按常规治疗外,并给予生长抑素6mg静脉滴注,维持24h,平均用药3.9(2～6.5)d,比较两组的疗效。结果治疗组胃肠平均减压量为(227±152)mL/d,明显少于对照组(522±186)mL/d(P<0.05);治疗组腹痛、腹胀和肛门恢复排气较对照组明显改善(P<0.05);两组中转手术率无差异(P>0.05),但治疗组出现肠坏死者(1例)显著少于对照组(6例)(P<0.05);KPS分值治疗组为57±6,对照组为44±8(P<0.05)。结论在肠梗阻常规治疗基础上,早期加用生长抑素静脉滴注能明显改善各型肠梗阻患者临床症状,虽不能减少其手术治疗率,但能降低肠坏死发生率。

Objective To investigate the effects of early application of somatostatin in non-surgical treatment of adhesive intestinal obstruction. Methods A total of 131 cases of different types of intestinal obstruction due to adhesions were treated in our hospotal during the recent seven years, The 131 patients were divided into treatment group （71 cases, Stilamin treatment ） and control group （60 cases, only conventional treatment ）. Patients in treatment group were give conventional treatment together with stilamin 6 mg given by intravenous drip 24 h continuously, average 3.9 （ 2 - 6.5 ） days. The efficacy between the two groups after treatment was compared. Results The gastrointestinal decompression fluid from the treatment group was significantly less than that of the control group, [ （ 227 ± 152 ） mL/d, （ 522 ±186 ） mL/d, respectively （ P 〈 0.05 ） ] . Abdominal pain, abdominal distension, and passage of flatus were significantly improved in treatment group than that in control group （ P 〈 0. 05 ）. The two groups had no difference in rate of conversion to operation （ P 〉 0.05 ）. There was one case of intestinal necrosis in treatment group which was significantly less than 6 cases in control group （ P 〈 0. 05 ）. KPS scores of the treatment group and the control group were 57 ± 6 and 44 ± 8, respectively （ P 〈 0.05 ）. Conclusions Basic conventional therapy plus early intravenous infusion of somatostatin can markedly improve the clinical symptoms of various types of intestinal obstruction. Moreover, it can reduce the incidence of intestinal necrosis, but does not reduce the operation rate.