腹腔镜胃癌根治术围手术期使用生长抑素对减轻胰腺损伤的影响

Preoperative use of somatostatin for prevention of pancreatic injury caused by laparoscopic radical gastrectomy

目的：比较术前使用与术后使用生长抑素与对减轻腹腔镜胃癌根治术所致胰腺损伤的疗效差异。方法：50例拟行腹腔镜胃癌根治术的患者随机均分为观察组（术前12~24 h开始使用生长抑素,术中及术后维持）或对照组（术后使用生长抑素）,5例患者中途退出研究,最终观察组纳入22例,对照组23例。比较两组相关临床指标。结果：两组一般资料及术前感染、营养指标差异均无统计学意义（均P〉0.05）。与对照组比较,观察组术后第1天腹腔引流量明显低于对照组（P=0.016）,但术后总引流量两组无明统计学差异（P〉0.05）;两组间围手术期血清淀粉酶浓度、腹腔引流液淀粉酶含量、术后感染与营养指标、引流管拔除时间、胃肠动力恢复与并发症情况均无统计学差异（均P〉0.05）。结论：术前、术后使用生长抑素比较,在减轻腹腔镜胃癌根治术所致胰腺损伤方面无明显差异。

Objective：To compare the effective difference between preoperative and postoperative use of somatostatin in reducing the degree of pancreatic injury caused by laparoscopic radical gastrectomy.Methods：Fifty patients scheduled to undergo laparoscopic radical gastrectomy were equally randomized into observational group（somatostatin treatment started 12-24 h before operation and continued during and after operation） or control group（somatostatin treatment started after operation）,and 22 cases in observational group and 23 cases in control group were finally included due to 5 cases that dropped out of the study before completion.The relevant clinical variables between the two groups were compared.Results：There was no significant difference in general conditions and preoperative infectious and nutritional factors between the two groups（all P〉0.05）.In observational group compared with control group,the postoperative day-1 drainage volume was significantly lower than that in control group（P=0.05）,but the total drainage volume showed no significant difference（P=0.016）.No significant difference was noted between the two groups in respects of perioperative serum amylase level,drainage fluid amylase level,postoperative infectious and nutritional factors,time to drainage tube removal,time to gastrointestinal recovery,and incidence of complications（all P〉0.05）.Conclusion：Preoperative use of somatostatin has no obvious superiority compared with postoperative somatostatin treatment in alleviating pancreatic injury caused by laparoscopic radical gastrectomy.