奥曲肽不同给药方式在恶性肠梗阻治疗中的应用研究

Application of different routes of octreotide administration in the treatment of malignant bowel obstruction

目的研究奥曲肽每8 h皮下注射0.2 mg和持续静脉泵入25μg/h两种给药方式在恶性肠梗阻治疗中的作用。方法收集恶性肠梗阻患者102例,采用简单随机分组方法将患者分为皮下注射组(n=52)和持续静脉泵入组(n=50)。观察两组患者治疗第0天、第3天、第5天和第7天的临床症状改善情况、胃肠减压引流量、电解质水平、卡氏评分变化及不良反应等指标。结果与治疗前比较,治疗后两组患者的呕吐次数、胃液引流量减少,腹痛症状减轻,卡氏评分改善,血钾、血钠和血氯水平升高,差异均有统计学意义(P﹤0.05)。但两种给药方式的疗效比较,差异无统计学意义(P﹥0.05)。结论奥曲肽皮下注射和持续静脉泵入均能明显改善恶性肠梗阻患者的症状,减少胃液引流量。两种给药方式的治疗效果相当,均无严重不良反应发生。其中皮下注射对日常活动影响小,更易为患者所接受。

Objective To investigate the effectiveness of 0.2 mg octreotide injected subcutaneously every 8 hours and 25 μg/h octreotide given by continuous intravenous pumping in the treatment of malignant bowel obstruction. Method Totally 102 cases of patients with malignant bowel obstruction were enrolled and divided into subcutaneous injection group （n=52） and continuous intravenous pumping group （n=50） by simple randomization method. The improvement of clinical symptoms, drainage of gastrointestinal tract decompression, electrolyte level, Karnofsky score （KPS score） and adverse reactions were recorded for these two groups on day 0, day 3, day 5 and day 7 during the period of therapy. Re-sult When compared with the conditions before treatment, the vomiting episodes and drainage of gastrointestinal tract de-compression decreased, abdominal pain was alleviated, KPS score was improved, the serum potassium, sodium and chlo-ride levels increased after treatment, and all the differences reached statistical significance （P〈0.05）. However, there was no statistically significant difference of curative effect between two administration routes（P〉0.05）. Conclusion Both oc-treotide subcutaneous injection and continuous intravenous pumping routes can significantly improve the symptoms and reduce the drainage of gastrointestinal tract in patients with malignant bowel obstruction. These two administration routes have equivalent curative effects without any serious adverse reactions. Of the two administration routes, subcutaneous in-jection has less impact on patients＆#39;daily life, and is more acceptable to patients.