奥曲肽治疗粘连性肠梗阻疗效及对患者血清血管活性肠肽水平影响观察

Clinical Observation of Octreotide in Treatment of Adhesive Intestinal Obstruction and its Influence on Serum Vasoactive Intestinal Peptide Levels

目的:观察奥曲肽治疗粘连性肠梗阻的临床疗效,探讨其对患者血清血管活性肠肽(VIP)水平的影响。方法:腹部手术后肠梗阻患者96例随机分为观察组(n=48)和对照组(n=48)。对照组予常规治疗,观察组在此基础上加用奥曲肽注射液0.1 mg,ih q8h。观察两组患者治疗前和治疗24 h后血清VIP水平的变化,比较两组腹痛缓解时间、肛门排气时间、胃肠减压量和药品不良反应。结果:治疗24 h后,两组患者血清VIP水平、腹痛评分等指标均较治疗前明显改善(P<0.05),且观察组明显优于对照组(P<0.05)。观察组的腹痛缓解时间、肛门排气时间明显短于对照组(P<0.05),胃肠减压量低于对照组(P<0.05),两组药品不良反应轻微。结论:奥曲肽能显著降低粘连性肠梗阻患者血清VIP水平,可能是奥曲肽治疗肠梗阻的一个新的作用机制。

Objective： To discuss curative effect of octreotide onadhesive intestinal obstruction after abdominal operation and its influence on serum vasoactive intestinal peptide（ VIP） levels. Methods： All 96 cases of patients with adhesive intestinal obstruction after abdominal operationwere selected and divided into observation group（ n = 48） and control group（ n = 48） at random. The control group was given routine medical treatment. The observation group was additionally given 0. 1 mg octreotide by hypodermic injection,q8 h. The changes of serum VIP levels of patients in two groups after the medical treatment of 24 hours were obsearved. The abdominal pain relief time,anus exhausting time,gastrointestinal decompression amount and adverse drug reaction of two groups were compared. Results： After 24 hours＇ medical treatment,the serum VIP levels and the abdominal pain score of patients in two groups were obviously improved than before（ P〈0. 05）,and the observation group was superior to the control group（ P〈0. 05）. The time for abdominal pain relief and anus exhaust time was significantly short in observation group than that in control group（ P〈0. 05）. The gastrointestinal decompression amount were significantly decreased in observation group as compared with control group. The both two groups had very little adverse drug reaction. Conclusion： Octreotide could significantly reduce the serum VIP level of adhesive intestinal obstruction patients,which might be a new mechanism of treatment of intestinal obstruction.