糖皮质激素与奥曲肽治疗术后早期炎性肠梗阻临床疗效分析

Comparison of the effects of glucocorticoids and octreotide in treatment of early postoperative inflammatory small bowel obstruction

目的比较糖皮质激素与奥曲肽治疗术后早期炎性肠梗阻的疗效,为临床治疗提供参考依据。方法选取2010年4月～2013年4月普外科收治的术后早期炎性肠梗阻患者72例,将患者按照随机数字表法分为奥曲肽治疗组（观察组）36例与糖皮质激素治疗组（对照组）36例,比较两组患者的实验室指标和临床症状缓解时间。结果观察组腹痛消失时间、腹胀消失时间、肛门排气时间、肠鸣音恢复时间分别为（1.17±0.54）、（3.48±1.27）、（3.37±1.25）、（2.38±1.04）天,均低于对照组（1.78±0.74）、（4.21±1.77）、（4.28±1.61）、（3.11±1.19）天,差异有统计学意义（P〈0.05）;治疗后两组患者hs-CRP、TNF-α、IL-6、LPS均低于治疗前,观察组下降水平优于对照组,差异有统计学意义（P〈0.05）。结论奥曲肽治疗术后早期炎性肠梗阻疗效优于糖皮质激素,对血浆炎性介质水平有一定调节作用,缩短了临床症状缓解时间,值得临床进一步研究。

Objective To investigate the effects of glucocorticoids and octreotide in treating early postoperative inflammatory small bowel obstruction and provide reference for clinical treatment.Methods 72 patients with early postoperative inflammatory small bowel obstruction were randomly divided into observation group（octreotide group,n=36）and control group（glucocorticoid group,n=36）.The laboratory indexes and clinical symptoms time were compared between the two groups.Results The pain disappearing time,anal exhaust time,hepatic portal exhaust time and recovery time of bowel sound of observation group were lower than the control group（P〈0.05）.The hs-CRP,TNF-α,IL-6 and LPS after treatment were lower than that before treatment（P〈0.05）.Conclusion Octreotide in treatment of early postoperative inflammatory small bowel obstruction effect is significant,which has a certain regulation effect on plasma levels of inflammatory mediators and the clinical symptoms.