经鼻型肠梗阻导管联合奥曲肽注射液治疗对术后早期炎性肠梗阻的效果观察

Effect of Transnasal Ileus Catheter Combined with Octreotide Injection on Early Postoperative Inflammatory Ileus

目的 探讨经鼻型肠梗阻导管联合奥曲肽注射液治疗术后早期炎性肠梗阻(EPII)的效果。方法 选取2018年8月—2022年8月收治的138例EPII,根据治疗方法不同分为奥曲肽组、导管组及联合组各46例。奥曲肽组予奥曲肽注射液治疗,导管组予经鼻型肠梗阻导管治疗,联合组予经鼻型肠梗阻导管联合奥曲肽注射液治疗。比较3组治疗后临床疗效、胃肠功能指标及不良反应发生率,分析3组治疗前后肠神经递质因子及肠黏膜屏障功能指标变化。结果 治疗后,联合组治疗总有效率为95.65%(44/46)高于导管组的78.26%(36/46)和奥曲肽组的71.74%(33/46)(P<0.05)。联合组首次肛门排气、首次自主排便、腹痛腹胀缓解、肠鸣音恢复及住院时间均短于导管组和奥曲肽组(P<0.05)。治疗后,3组血管活性肠肽、一氧化氮及内毒素、二胺氧化酶、D-乳酸水平明显降低,且联合组显著低于导管组和奥曲肽组(P<0.05)。3组不良反应发生率比较差异无统计学意义(P>0.05)。结论 经鼻型肠梗阻导管联合奥曲肽注射液治疗可有效促进EPII患者胃肠功能恢复,平衡肠神经递质因子,提高肠黏膜屏障功能,减少内毒素异位,促使患者病情转归,缩短治疗时间。

Objective To investigate the effect of transnasal ileus catheter combined with Octreotide injection in the treatment of early postoperative inflammatory ileus(EPII).Methods A total of 138 EPII patients admitted from August 2018 to August 2022 were selected and divided into Octreotide group(n=46),catheter group(n=46)and combination group(n=46)according to different treatment methods.The Octreotide group was treated with Octreotide injection,the catheter group was treated with transnasal ileus catheter,and the combination group was treated with transnasal ileus catheter combined with Octreotide injection.The clinical efficacy,gastrointestinal function indexes and incidence of adverse reactions of the three groups after treatment were compared,and the changes of intestinal neurotransmitter factors and intestinal mucosal barrier function indexes before and after treatment were analyzed.Results After treatment,the total effective rate of combination group was 95.65%(44/46),which was higher than that of catheter group[78.26%(36/46)]and Octreotide group[71.74%(33/46)](P<0.05).Time to first anal exhaust,time to first spontaneous defecation,relief of abdominal pain and distension,bowel sound recovery and length of hospital stay in combination group were shorter than those in catheter group and Octreotide group(P<0.05).After treatment,the levels of vasoactive intestinal peptide,nitric oxide,endotoxin,diamine oxidase and D-lactic acid in the three groups were significantly decreased,and significantly lower in the combination group than in catheter group and Octreotide group(P<0.05).There was no significant difference in the incidence of adverse reactions among the three groups(P>0.05).Conclusion The transnasal ileus catheter combined with Octreotide injection can effectively promote the recovery of gastrointestinal function in EPII patients,balance intestinal neurotransmitter factors,improve intestinal mucosal barrier function,reduce endotoxin ectopia,promote the prognosis of patients,and shorten the duration of treatment.