质子泵抑制剂联合生长抑素治疗肠梗阻疗效观察

Efficacy of proton pump inhibitor combined with somatostin used in bowel obstruction

目的探讨质子泵抑制剂（proton pump inhibitor PPI）和生长抑素（somatostin SS）联合使用治疗肠梗阻的临床疗效。方法将97例非手术治疗的肠梗阻患者按入院先后随机分为试验组（50例）和对照组（47例）。试验组入院即联合使用SS（善宁）和PPI（奥美拉唑），对照组单用SS（善宁），两组其他基础治疗相同。于治疗后24、48、72、96、120h检查患者症状，体征，腹部X片，血常规和胃肠减压液的性状、量、pH值。结果试验组中46例非手术治疗成功，平均症状缓解时间为（28±4．7）h，3—5d（平均3．6d）后症状消失，4例在非手术治疗过程中中转手术，非手术治疗治愈率为92．00％；对照组40例非手术治疗成功，平均症状缓解时间为（46±5．6）h，4—6d（平均5．2d）后症状消失，7例在非手术治疗过程中中转手术，非手术治疗治愈率为85．11％。两组在住院时间、住院费用差异有统计学意义。结论SS和PPI联合使用，能提高非手术治疗肠梗阻的疗效，缩短住院时间、降低住院费用。

Objective To evaluate the clinical effect of proton pump inhibitor （PPI） combined with somatostin（SS） in non - surgical treatment of bowel obstruction. Methods The clinical data of 97 patients with intestinal obstruction randomly divided into experimental group （ n = 50 ） and control group （ n = 47 ） were analyzed. The experimental group was treated with PPI （ Omeprazole ） and SS （ Oetreotide ）, and the control group was treated with SS （ Octreotide ） only ; Basal treatment of both were same. Patients＇ symptom, sign, abdominal plain film, blood routine examination, and the character, volume and pH value of gastrointestinal decompression fluid at 24 h ,48 h ,72 h ,96 h, 120 h after treatment were examined. Results In experimental group, 46 cases were healed, of which the average time of symptom remission was 28 ＋4.7 h and symptoms disappeared after 3 -5 days（ mean 3.6 days） ;4 cases were treated by emergency surgery,of which the cure rate was 92.00%. In control group,40 cases were healed, of which the average time of symptom remission was 46 ＋ 5.6 h and symptoms disappeared after 4 - 6 days （ mean 5.2 days） ; 7 cases were treated by emergency surgery, of which the cure rate was 85.11%. There were significant differences in hospital stay and cost between experimental and control groups. Conclusion Using SS combined with PPI in non - surgical treatment of bowel obstruction can improve clinical effect, reduce gastrointestinal mucosa trauma, curtail hospital stay and reduce cost.