生长抑素在胃癌根治术中的应用研究

Study of application of somatostatin on radical gastrectomy

目的探讨生长抑素对接受标准D2根治手术并获得R0切除的胃癌病人胃肠道功能恢复及炎症反应的影响。方法 50例可获得R0切除的胃癌病人在接受标准D2根治手术后,随机接受生长抑素(25例)或空白治疗(25例)。生长抑素组术后给予生长抑素治疗(施他宁6mg/d、微泵24h维持、连续3d)。所有患者术前1d和术后1、7天抽取空腹静脉血并检测C-反映蛋白和炎症介质肿瘤坏死因子(TNF-α)、白介素6(IL-6)、血清白蛋白、前白蛋白、转铁蛋白,并观察患者术后胃肠道功能恢复情况。结果两组的CRP、TNF-α和IL-6等指标在术后第1d、第7d均较术前增高(P<0.05),试验组增高的幅度明显低于对照组(P<0.01);同时试验组胃肠功能恢复较对照组明显改善。结论生长抑素可显著减轻术后炎症反应,从而加快病人术后康复。

Objective To investigate the effect of somatostatin on gastrointestinal function and systemic inflammatory responses in treatment of postoperative patients subjected to R2 radical gastrectomy and got R0 resection. Methods Fifty patients with RO resection were divided into two groups （n=25, each）, somatostatin group （patients received 6mg/d of somatostatin, continuous infusion for 3 days） and control group （untreated patients with somatostatin）. Venous blood at first and seventh day was collected for detection of C-reactive protein, TNF-cL, IL-6, serum albumin, prealbumin and transferrin. Also, the gastrointestinal function restoraton was observed after administration with somatostatin. Results Serum C-reactive protein, TNF-c~, IL-6, serum albumin, prealbumin and transferrin in patients of somatostatin group were increased significantly when compared with controls, but the levels in somatostatin group were lower than in control group （P〈0.05）. The time for restoration of gastrointestinal function in the treatment group was shortened, showing significant differences which compared with controls （P 〈0.01）. Conclusion Somatostatin can attenuate systemic inflammatory responses for patients underwent radical gastrectomy, make a quick recovery and for the patients