奥曲肽在门静脉高压症病人术后应用的临床研究

Clinical use of octreotide in patients with portal hypertension

目的研究奥曲肽对于降低门静脉高压症术后并发症发生率的效果。方法将2010年4月至2011年11月收治的100例门静脉高压症病人用掷硬币法随机分为两组，均行断流术或分流术，其中48例术后2h使用奥曲肽25μg／h（奥曲肽组），连续3d；另52例不使用任何生长抑素（对照组）。比较两组术后实验室结果、腹腔引流量、术后并发症、住院时间等。结果所有病人术后恢复顺利，奥曲肽组术后血红蛋白、红细胞压积、血浆白蛋白均高于对照组，腹腔引流量少于对照组，奥曲肽组术后胰漏、腹腔积液发生率明显低于对照组。结论术后早期使用奥曲肽能够降低门静脉压力，显著减轻手术创面的渗血、减少腹腔引流量、预防胰漏的发生。

Objective To study the efficacy of octreotide in patients with portal hypertension to reduce the incidence of postoperative complication. Methods From April 2010 to November 2011, 100 patients with portal hypertension were randomly divided into two groups： 48 cases receiving octreotide at 2nd h after pericardial devascularization or splenorenal shunt, 25μg/h for 3 days （octreotide group）, and 48 cases not receiving octreotide therapy （control group）. Laboratory tests, abdominal drainage, complication, and hospital day between two groups were compared. Results All patients recovered well after operation. The levels of postoperative hemoglobin, hematocrit, and serum albumin in octreotide group were significantly higher, and the amount of abdominal drainage was significantly less than in control group. The incidence of postoperative pancreatic leakage and abdominal collection was significantly lower in octreotide group than in control group. Conclusion Early postoperative use of octreotide could decrease portal hypertension, significantly reduce the amount of surgical wound bleeding and abdominal drainage, and also prevent the occurrence of pancreatic leakage.