施他宁治疗恶性肠梗阻30例疗效观察

Observation of the curative effect of Stilamin on 30 cases of malignant intestinal ostruction

目的探讨生长抑素在不能行手术治疗的胃肠道肿瘤所致的恶性肠梗阻治疗中的作用。方法2008年1月～2010年12月将收治的30例胃肠道恶性肿瘤所致的肠梗阻患者随机分为常规治疗对照组15例和生长抑素治疗组15例，对照组给予常规治疗，治疗组给予常规治疗加生长抑素（每天6mg静脉滴注，维持24h）3～12d，比较2组治疗前后的疗效。结果治疗组临床症状较对照组明显改善，腹痛、腹胀缓解率分别为80．0％、53．3％（P〈0．05）；肛门恢复排气排便比率分别为930％、600％（P〈0.01）；胃肠平均减压量明显少于列照组，分别为（216±158）mL／d、（522±184）mL／d、（P〈0.001），14例患者腹部平片显示肠管税气积液减少消失，血浆C反应蛋自治疗前后差异显著；生活质量明显改善。结论在常规治疗的基础上，应用生长抑素治疗胃肠道肿瘤所致恶性肠梗阻，能明显改善患者的不适症状和生活质龟，临床应用前景看好。

Objective To investigate the effect of Somatostatin on malignant intestinal obstruction caused by gastrointestinal tumors which is not suitable for operation. Method From Jan- uary 2008 to December 2100, 30 cases of malignant intestinal ostruction were randomly divided into treatment group and control group. The treatment group received routine therapy combined with Somatostatin （6 mg/d） by 24 hours continuous infusion for three to twelve days. The clinical efficacy was observed and compared in both groups. Results The healing effect of the treatment group was significantly higher than that of the control group. The remission rate of abdominal pain and abdominal distention was 80.0 % and 53.3 % respectively （P 〈 0.05）. The exhaust of anus was earlier [ （93.0% and 60.0% ） ] （P〈0.01）. The average volume of gastroenteral decompression reduced more rapidly [ （216 ± 158） ml/d and （522 ± 184） ml/d] （P〈0. 001）. No fluid- air in the intestinal and in the colon was observed at the 14 patients＇ plain abdominal radiography. C reactive protein was significantly different before and after treatment. Life quality was improved significantly. Conclusion On the basis of conventional therapy, Somatostatin is efficient in treatment of malignant intestinal obstruction caused by gastrointestinal tumors. It can improve clinical symptoms and improve life quality. It is worthy of promotion and application.