腹部大手术后重组人生长激素的应用

The application of recombinant human growth hormone(rhGH) after large abdominal operations

目的 观察重组人生长激素 (rhGH)对促进腹部大手术患者术后代谢、免疫状态及康复等方面的影响。方法 对49例腹部大手术病例进行随机对照研究 ,治疗组于术后皮下注射rhGH ,观察患者在蛋白质代谢、免疫球蛋白水平、空腹血糖水平、切口愈合情况及术后精神状态等方面的变化。 结果 (1)rhGH治疗组患者在治疗后第7天 ,血浆白蛋白、前白蛋白和转铁蛋白已基本恢复到术前水平 ;而对照组各项蛋白指标的改善明显迟于治疗组 ,在使用后第10天才恢复到术前水平 ;(2)两组患者术后均出现不同程度的免疫球蛋白表达减少 ,治疗组在治疗后第7天逐渐恢复 ,而对照组术后免疫球蛋白水平持续较低 ;(3)治疗组患者使用前、使用后第1、3、5、7天的总体血糖水平并无显著变化 ,仅4名患者的血糖出现异常波动 ;(4)治疗组患者切口感染和切口裂开的发生率低于对照组 ;(5)治疗组在术后精神状态的恢复方面明显好于对照组。结论 腹部大手术后的患者 ,应用rhGH有利于增加蛋白质合成 ,提高机体免疫力 ,促进伤口生长修复 ,加快术后疲劳的恢复。在胰岛调节功能正常的患者中 。

Objective To observe the effects of recombinant human growth hormone (rhGH,Sizen) on the changes of metabolism and immune function,the restoration in the postoperative therapy of large abdominal operations.Methods Forty nine cases of large abdominal operations were includcd in this randomized placebo-controlled trial.Thirty one patients in study group received rhGH subcutaneously from the 2nd day after operation for 5 days,18 cases in the control group received normal saline as placebo.The effects on all patients were evaluated in terms of protein metabolism,immunoglobulin level,blood sugar level,wound healing,and general condiions.Results (1)The albumin,prealbumin and transferrin of rhGH in study group rapidly reached the normal levels,while those of control group rose more slowly.(2)Each group had a marked decline of immunoglobulin which became normal at the 7th days after operation in therapy group and remained lower in control group.(3)On a whole,there were no changes in blood sugar levels with rhGH therapy except 4 cases.(4)The incident rates of wound infection and rupture in study group were lower than those of control group.(5)The changes of general conditions were satisfying in therapy group.Conclusions The application of rhGH after large abdominal operations can promote protein synthesis,enhance immunity and reduce the healing time and fatigue degree after the operation.In those who have normal regulative functions in their pancreatic islet,it is safe and effective to apply the rhGH for short period.