醋酸奥曲肽在恶性肿瘤所致肠梗阻治疗中的临床效果观察

Effectiveness of octreotide in treatment of malignant bowel obstruction induced by inoperable gastrointestinal carcinoma

目的：探讨醋酸奥曲肽对不能手术治疗的胃肠道恶性肿瘤所致肠梗阻临床疗效。方法：回顾性分析2007年8月-2013年2月收治的恶性胃肠道肿瘤所致的恶性肠梗阻患者60例,分为治疗组30例和对照组30例。对照组给予常规治疗,包括禁食、胃肠减压、纠正水电解质紊乱和酸碱失衡、全胃肠外营养支持治疗,治疗组给予常规治疗加醋酸奥曲肽3~12 d,比较2组疗效。结果：治疗组临床症状较对照组明显改善,腹痛、腹胀缓解率分别为80%和53.3%（P=0.029）,肛门恢复排气、排便比率分别为60%和23.3%（P=0.001）,治疗组胃肠平均减压量少于对照组,中位数分别为208 ml/d和498 ml/d（P=0.032）。结论：常规治疗加醋酸奥曲肽治疗胃肠道恶性肿瘤所致恶性肠梗阻能明显改善患者临床症状和有效提高生活质量。

Objective： To investigate the effectiveness of octreotide in treatment of malignant bowel obstruction（ MBO） due to inoperable gastrointestinal carcinoma. Methods： Retrospective analysis was carried out among 60 patients with MBO due to inoperable carcinoma from August 2007 to February 2013. All the patients were divided into two groups： a routine therapy control group（ n = 30） and an octreotide group（ n = 30）. The patients received routine therapy alone（ control） or combined therapy added with octreotide for 3 ~ 12 days. The effects in the two groups were observed and compared. Results： The clinical symptoms of abdominal distention and abdominal pain were significantly relieved in the octreotide group as compared with the control group（ 80% VS 53. 3%,P = 0. 029）. For the octreotide group,the rate of exhaust of anus was higher（ 60% VS 23. 3%,P = 0. 001） and the average volume of gastrointestinal decompression reduced more rapidly（ 208 ml / d VS 498 ml / d,P = 0. 032）. Conclusion： The administration of octreotide in combination with routine treatment is effective in the management of MBO. It can effectively relieve symptoms of MBO and improve the quality of life in patients.