重症颅脑损伤患者中生长抑素的应用研究

The research of application of somatostatin into severe craniocerebral injuried patients

目的探讨生长抑素应用于重症颅脑外伤患者的临床价值。方法41例重症颅脑损伤患者分为两组:A组(n=23)入住ICU后即予注射用生长抑素(思他宁)持续静脉泵入,250μg/h,维持72h。B组(n=18)不用思他宁,其他治疗措施同A组。记录消化道出血等胃肠道症状出现频率、营养指标、每天胰岛素的用量、患者预后等数据。结果A组胃肠道症状出现频率明显少于B组,一周后的营养指标优于B组,每天胰岛素的用量明显少于B组,两组患者一周后APACHEⅢ评分和两周内死亡率差异无统计学意义。结论生长抑素应用于重症颅脑外伤患者可以减少消化道出血的发生,更有助于肠内营养实施,改善营养指标,稳定血糖水平,但尚无可以改善患者预后的证据。

Objective To discuss the clinical value of Somatostatin （Stilamin） in severe craniocerebral injuried patients. Methods 41 severe craniocerebral injuried patients were divided into two groups：group A（n = 23）patients were sent to intense care unit and were continuously injected Somatostatin （Stilamin） for 72 hours,250 ug per hour. Group B（n = 18）with the same treatments as group A except for Somatostatin. The amount of gastroentero symptoms such as alimentary canal hemorrhage,the indexes of nutrition,the dosage of insulin every day,the prognosis of paitents were recorded. Results The amount of gastroentero symptoms and needing dosage of insulin in group A was smaller than that of group B,and the indexes of nutrition after a week were better than group B,APACHE Ⅲ grade after a week and death rate in two weeks were similar in the two groups. Conclusion Using Somatostatin （Stilamin） in severe craniocerebral injuried patients can reduce the rate of alimentary canal hemorrhage,benefit to udergo entero-nutrition,improve indexes of nutrition,stabilize the level of blood sugar,but no evidences are found to prove that it can reform the prognosis of these paitents.