奥曲肽联合腹腔镜肠粘连松解术治疗粘连性肠梗阻的临床效果

Clinical effect of octreotide combined with laparoscopic lysis of intestinal adhesions in the treatment of adhesive ileus

目的观察奥曲肽联合腹腔镜肠粘连松解术治疗粘连性肠梗阻的临床效果。方法回顾性分析2015年4月至2018年4月我院收治的90例粘连性肠梗阻患者的临床资料,根据手术方式的不同将其分为对照组和研究组,每组45例。对照组给予腹腔镜肠粘连松解术治疗,研究组给予奥曲肽联合腹腔镜肠粘连松解术治疗。比较两组的治疗效果。结果研究组排气时间、腹胀消失时间、饮食恢复正常时间及住院时间均显著短于对照组(P<0.05)。治疗3 d后,两组PA水平均升高,PCT、CRP、DAO、IL-6、TNF-α水平均降低,且研究组优于对照组(P<0.05)。治疗3个月后,两组SRSS评分均降低,且研究组低于对照组(P<0.05)。研究组术后并发症总发生率明显低于对照组,差异具有统计学意义(P<0.05)。结论奥曲肽联合腹腔镜肠粘连松解术治疗粘连性肠梗阻效果显著,可有效缓解患者的临床症状和炎症反应,促进患者快速恢复,有效改善患者的睡眠质量,具有显著的临床推广价值。

Objective To observe the clinical effect of octreotide combined with laparoscopic lysis of intestinal adhesions in the treatment of adhesive ileus.Methods The clinical data of 90 patients with adhesive ileus admitted in our hospital from April 2015 to April 2018 were retrospectively analyzed.According to the different operation methods,the patients were divided into control group and study group,with 45 cases in each group.The control group was treated with laparoscopic lysis of intestinal adhesions,and the study group was treated with octreotide combined with laparoscopic lysis of intestinal adhesions.The therapeutic effects of the two groups were compared.Results The time of exhaust,abdominal distention disappearance,diet return to normal and hospitalization in the study group were significantly shorter than those in the control group(P<0.05).After 3 d of treatment,the level of PA increased in both groups,and the levels of PCT,CRP,DAO,IL-6 and TNF-αdecreased in both groups,and those in the study group were superior to the control group(P<0.05).After 3 months of treatment,the SRSS score in both groups decreased,and that in the study group was lower than the control group(P<0.05).The total incidence of postoperative complications in the study group was significantly lower than that in the control group(P<0.05).Conclusion Octreotide combined with laparoscopic lysis of intestinal adhesions in the treatment of adhesive ileus has a significant effect,it can effectively alleviate the clinical symptoms and inflammatory response,promote the rapid recovery of patients,and effectively improve the sleep quality of patients,which has significant clinical promotion value.