联合应用生长抑素与泛影葡胺治疗粘连性肠梗阻的效果研究

Clinical effects of combination of somatostatin and Diatrizoate in patients with adhesive intestinal obstruction

目的探讨联合应用生长抑素14肽与泛影葡胺治疗粘连性肠梗阻的疗效及对炎性因子水平的影响。方法选取于2014年7月至2015年8月间本院收治的120例粘连性肠梗阻住院患者,随机分为单用生长抑素组、生长抑素+泛影葡胺组和对照组,每组各40例。对照组行胃肠减压、禁饮、禁食、抗感染、静脉营养、维持水电解质和酸碱平衡的常规治疗;单用生长抑素组在常规治疗的基础上加用生长抑素14肽治疗;生长抑素+泛影葡胺组除常规治疗外,联合应用生长抑素14肽和泛影葡胺治疗。观察三组患者的治疗效果以及TNF-α、IL-6及IL-8的变化。结果生长抑素+泛影葡胺组腹痛、腹胀减轻时间,排气、排便恢复时间,胃肠减压引流量、减压维持时间以及腹痛症状改善情况均优于对照组和单用生长抑素组,差异有统计学意义(P<0.05)。生长抑素+泛影葡胺组TNF-α、IL-6及IL-8水平下降速度较其他两组快,差异有统计学意义(P<0.05)。生长抑素+泛影葡胺组治愈时间和总治愈率均优于其他两组,且复发率低于低于其他两组,差异有统计学意义(P<0.05)。生长抑素+泛影葡胺组患者电解质紊乱情况、机体应激反应情况均轻于对照组和单用生长抑素组,差异有统计学意义(P<0.05)。结论生长抑素联合泛影葡胺可以明显缓解粘连性肠梗阻患者腹痛、腹胀等临床症状,降低TNF-α、IL-6及IL-8水平,减轻炎症反应,有较好的治疗效果,具有一定的临床推广应用价值。

Objective To investigate the clinical effects of combination of somatostatin and Diatrizoate and its effect on inflammatory markers in patients with adhesive intestinal obstruction Methods 120 patients with intestinal obstruction who were treated in our hospital from July 2014 to August 2015 were selected as study subjects.The patients were randomly assigned to three groups,namely Somatostatin group,Somatostatin ＋Diatrizoate group and control group,using random number table.The control group received conventional therapy,including decompression,fasting,regulated water balance and acid-base balance.Somatostatin ＋Diatrizoate group received somatostatin peptide 14 and Diatrizoate in addition to conventional therapy.Somatostatin group were treated with somatostatin peptide 14 in addition to conventional therapy.The therapeutic effects and changes of TNF-α,IL-6 and IL-8 were recorded.Results Time to relief of abdominal pain and bloating,time to anal exhaust and defecation,amount of decompression,relief of abdominal symptoms of Somatostatin＋Diatrizoate group were all better than those in control group and Somatostatin group,and the difference with the control group was statistically significant（P〈0.05）.The rates of decrease of TNF-α,IL-6 and IL-8 in Somatostatin＋Diatrizoate group were faster than in control group and Somatostatin group.The difference was statistically significant compared with the control group（P〈0.05）.Time to cure and overall effectiveness rate in Somatostatin＋Diatrizoate group were better than control group and Somatostatin group.The difference was statistically significant compared with the control group（P〈0.05）.The electrolyte imbalance and stress response of Somatostatin＋Diatrizoate group were all less signifciant than control group and Somatostatin group.The difference was statistically significant compared with the control group（P〈0.05）.Conclusion Somatostatin combined with diatrizoate can significantly alleviate abdominal pain, bloating and other symptoms of intestinal obstruction. They can reduce TNF-α, IL-6 and IL-8 levels, effectively control inflammation, effectively relieve intestinal obstruction.