经鼻肠梗阻导管联合奥曲肽治疗机械性肠梗阻的效果及对胃肠功能的影响

Effect of Transnasal Ileus Catheter Combined with Octreotide in Treating Mechanical Intestinal Obstruction and the Influence on Gastrointestinal Function

目的:探究经鼻肠梗阻导管(TIC)联合奥曲肽(OTT)治疗机械性肠梗阻(IO)的效果及对胃肠功能的影响。方法:选取2020年5月—2022年12月萍乡市人民医院收治的80例机械性IO患者,采用随机数字表法分为对照组与联合组,每组40例。对照组采用常规治疗,联合组在对照组基础上增加TIC联合OTT治疗。比较两组临床疗效、胃肠功能、血清指标、疼痛程度、生活质量及并发症。结果:联合组临床总有效率(95.00%)显著高于对照组(75.00%),差异有统计学意义(P<0.05)。联合组首次排便时间、排气时间、腹胀缓解时间、X线片梗阻消失时间及肠鸣音恢复时间分别为(65.63±8.47)、(69.45±7.33)、(63.47±5.39)、(83.46±8.11)、(31.04±5.78)h,均显著早于对照组的(86.77±9.68)、(79.37±8.55)、(78.41±8.97)、(96.47±9.32)、(43.56±6.22)h,差异均有统计学意义(P<0.05)。治疗后联合组血管活性肠肽(VIP)水平为(39.64±5.63)pg/mL,丙二醛(MDA)水平为(1.56±0.22)nmol/mL,均显著低于对照组的(57.43±7.48)pg/mL、(1.88±0.32)nmol/mL,差异均有统计学意义(P<0.05)。治疗后联合组视觉模拟评分法(VAS)评分显著低于对照组,胃肠道生活质量指数(GIQLI)评分显著高于对照组,差异均有统计学意义(P<0.05)。联合组并发症发生率(7.50%)显著低于对照组(25.00%),差异有统计学意义(P<0.05)。结论:在常规治疗基础上TIC联合OTT治疗机械性IO具有较好临床效果,可显著改善肠道功能、血清指标,对患者疼痛有显著缓解作用,同时显著提高患者生活质量,同时不良反应发生率低,具有安全性。

Objective:To investigate the effect of transnasal ileus catheter(TIC)combined with octreotide(OTT)in treating mechanical intestinal obstruction(IO)and the influence on gastrointestinal function.Method:A total of 80 patients with mechanical IO who were admitted to Pingxiang People's Hospital from May 2020 to December 2022 were randomly divided into the control group and the combination group with 40 cases in each group.The control group underwent conventional treatments,and the combination group was treated with TIC combined with OTT on the basis of conventional treatments.The clinical efficacy,gastrointestinal function,serum indexes,pain degree,quality of life,and complications were compared between groups.Result:The total effective rate of the combined group(95.00%)was significantly higher than that(75.00%)of the control group,the difference was statistically significant(P<0.05).The first defecation time,exhaust time,abdominal distension relief time,disappearance time of obstruction on X-ray and bowel sound recovery time in the combination group[(65.63±8.47),(69.45±7.33),(63.47±5.39),(83.46±8.11)and(31.04±5.78)h]were significantly earlier than those[(86.77±9.68),(79.37±8.55),(78.41±8.97),(96.47±9.32)and(43.56±6.22)h]in the control group,with statistically significant differences(P<0.05).After treatment,the levels of vasoactive intestinal peptide(VIP)and malondialdehyde(MDA)in the combination group[(39.64±5.63)pg/mL and(1.56±0.22)nmol/mL]were significantly lower than those[(57.43±7.48)pg/mL and(1.88±0.32)nmol/mL]in the control group,with statistically significant differences(P<0.05).The combination group had lower visual analogus scale(VAS)score and higher GIQLI score than those in the control group,with statistically significant differences(P<0.05).The incidence of complications in the combination group(7.50%)was significantly lower than that in the control group(25.00%),the difference was statistically significant(P<0.05).Conclusion:On the basis of conventional treatments,TIC combined with OTT is effective in treating mechanical IO,which can significantly improve intestinal function and serum indexes and relieve pain while improving quality of life of the patients.In addition,the incidence of adverse reactions is low,which indicates high safety.