生长抑素联合地塞米松对腹部术后早期炎性肠梗阻的疗效及对胃肠功能和血清LPS IL-6 hs-CRP的影响

Somatostatin Combined with Dexamethasone on Early Postoperative Inflammatory Ileus after Abdominal Operation and its Influence on the Gastrointestinal Function and LPS IL-6 hs-CRP Levels in Patients

目的:探讨生长抑素联合地塞米松对腹部术后早期炎性肠梗阻的疗效及对患者胃肠功能和血清内毒素(LPS)、白细胞介素-6(IL-6)、高敏C反应蛋白(hs-CRP)的影响。方法:研究对象选自我院2015年5月至2017年6月收治的138例腹部术后早期炎性肠梗阻患者,依据患者的入院顺序做编号,并采用简单随机数字表分成观察组与对照组两组,每组69例。两组患者均给予常规对症支持治疗,对照组在此基础上联合给予地塞米松治疗,观察组在对照组基础上联合给予生长抑素治疗。比较两组临床疗效、胃肠功能恢复情况及治疗前后血清LPS、IL-6、hs-CRP水平变化情况。结果:观察组治疗总有效率为91.30%(63/69),与对照组[75.36%(52/69)]相比显著上升(P<0.05)。观察组肠鸣音恢复时间、肛门排气恢复时间、腹痛腹胀缓解时间、恶心呕吐消失时间均显著短于对照组(P<0.01)。相对于治疗前,两组治疗后血清LPS、IL-6、hs-CRP水平均有明显下降(P<0.01),且治疗后观察组以上指标均明显低于对照组(P<0.01)。结论:生长抑素联合地塞米松治疗腹部术后早期炎性肠梗阻可有效促进胃肠功能的恢复,缓解炎症反应,疗效确切。

Objective:To investigate the clinical efficacy of somatostatin combined with dexamethasone on early postoperative inflammatory ileus after abdominal operation and its influence on patients'gastrointestinal function and their serum lipopolysaccharide(LPS),interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)levels.Methods:The subjects of this study were selected from 138 cases of patients with early postoperative inflammatory ileus after abdominal operation admitted in our hospital from May 2015 to June 2017.The patients were according to simple random number table method were divided into observation group and control group,each with 69 cases.Besides conventional treatment given to both groups,dexamethasone was adopted to the control group in addition,and combination of somatostatin and dexamethasone was given to the observation group additionally.The clinical efficacy,the recovery status of gastrointestinal function,and changes of serum LPS,IL-6,hs-CRP levels before and after treatment were compared between the two groups.Results:The overall effective rate of the observation group was 91.30%(63/69),much higher than 75.36%(52/69)of the control group(P<0.05).The time for resuming of peristaltic sound,postoperative exhausting,release of abdominal pain and distention,extinction of nausea and vomitting that the observation group took was significantly shorter than the time the control took(P<0.01).After treatment,both groups saw great decrease in serum LPS,IL-6 and hs0CRP levels as compared with those before treatment(P<0.01),and observation group had remarkably lower levels of above indicators than the control group did at the identical time points after treatment(P<0.01).Conclusion:Application of somatostatin combined with dexamethasone in treating early postoperative inflammatory ileus after abdominal operation is effective in promoting the recovery of gastrointestinal function and mitigating inflammatory reactions.