奥曲肽对急性胰腺炎患者黏膜保护功能与胃动力学的影响

Gastric Mucosal Protective Function of Octreotide and Its Influence on Gastric Dynamics in Application for Treating Patients with Acute Pancreatitis

目的：探讨奥曲肽用于急性胰腺炎对黏膜保护功能及胃动力学的影响。方法选择2013年4月至2014年2月收治的42例急性胰腺炎患者，按照随机数字表法分为观察组（21例）和对照组（21例）。两组均给予常规治疗，观察组在此基础上静脉注射100μg奥曲肽注射液，后用微泵以25μg/h的速率匀速维持，连续使用6~7 d。对两组患者的黏膜保护功能及胃动力变化进行观察比较，评定临床疗效。结果两组患者治疗前血浆降钙素原、D－乳酸水平、血清内毒素水平比较，差异无统计学意义（ P＞0.05），治疗后均显著下降，且观察组降幅显著优于对照组（ P＜0.05）。治疗后，两组患者平均肠胃减压引流量无显著性差异（ P＞0.05）；但观察组的腹围减少量为（43±1.04）cm，明显大于对照组的（28±1.15）cm，并且排气、腹胀消失情况均明显优于对照组（ P＜0.05）。观察组的临床总有效率为95.24%，明显高于对照组的76.19%（ u=2.2838，P=0.0224）。结论奥曲肽用于急性胰腺炎患者的治疗，可明显改善黏膜保护功能及胃动力学指标，值得临床推广。

Objective To research the gastric mucosal protective function of octreotide and its influence on gastric dynamics in treating the patients with acute pancreatitis. Methods 42 cases of acute pancreatitis in our hospital from April 2012 to June 2014 were select-ed and divided into the observation group （ 21 cases ） and the control group （ 21 cases ） according to the random number table method. The two groups were given the conventional treatment. On this basis the observation group was intravenously injected by oc-treotide 100ug, and then maintained with a constant speed of 25 μg/h by using the micropump for continuous 6-7 d. The mucosal protection function and the gastric dynamic changes were observed and compared between the two groups. The curative effects were as-sessed in the two groups. Results The plasma procalcitonin, D-lactate and serum endotoxin levels before treatment had no statistical differences between the two groups （ P 〉 0. 05 ） , but which after treatment in the two groups were significantly decreased, moreover the decline amplitude in the observation group was significantly better than that in the control group, the difference was statistically signifi-cant （ P 〈 0. 05 ） . The mean gastrointestinal decompression drainage amount after treatment had no statistically significant difference be-tween the two groups （ P 〉 0. 05 ）;however, the decrement amount of abdominal circumference in the observation group was （ 43 ± 1. 04 ） cm, which was significantly greater than （ 28 ± 1. 15 ） cm in the control group, moreover the exhaust, abdominal distension disappearance situation in the observation group was significantly superior to that in the control group, the difference was statistically significant （ P 〈0. 05 ） . The effective rate after treatment in the observation group was 95. 24%, which was significantly higher than 76. 19% in the control group, the difference between them was statistically significant （ u=2. 2838, P=0. 022 4 ） . Conclusion Octreotide has an impor-tant influence role on the gastric mucosal protection function and gastric dynamics of the patients with acute pancreatitis, which is worth being widely promoted and used.