中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
18期
7-9
,共3页
奥曲肽%内毒素血症%肠屏障功能障碍
奧麯肽%內毒素血癥%腸屏障功能障礙
오곡태%내독소혈증%장병장공능장애
Octreotide%Endotoxemia%Intestinal barrier dysfunction
目的 观察奥曲肽持续静脉泵入在肠源性内毒素血症患者中的治疗效果.方法 肠梗阻非手术治疗患者80例,34例常规治疗者设为Ⅰ组,46例常规治疗联合奥曲肽24h持续静脉泵入者设为Ⅱ组,于治疗前和治疗后24h、48 h、4d检测白细胞计数(WBC)、二胺氧化酶(DAO)、D-乳酸(D-LA)、内毒素含量.结果 两组治疗后48h WBC、DAO、D-LA、内毒素含量均达到峰值,两组治疗后24h WBC、DAO、D-LA、内毒素含量比较差异无统计学意义(P＞0.05).Ⅱ组治疗后48 h、4dWBC、DAO、D-LA、内毒素含量均低于Ⅰ组,治疗后48 h比较差异有统计学意义[(18.40±0.10)×109/L比(20.60±2.36)× 109/L、(6.12±1.02)kU/L比(8.02±1.54)kU/L、(2.14±0.21) mg/L比(3.34±0.04) mg/L、(1.65±0.16) kEU/L比(2.23±0.36) kEU/L](P＜ 0.01),治疗后4d比较差异无统计学意义(P＞0.05).Ⅱ组患者治疗后48h体温、胃肠减压量、肛门排气时间分别为(37.60±3.01)℃、(320.00±76.14) ml/d、(54.00±0.94)h,均优于Ⅰ组的(38.50±2.21)℃、(500.00±80.32) ml/d、(68.00±1.02)h,差异有统计学意义(P＜0.01).结论 持续静脉泵入奥曲肽能有效保护肠黏膜屏障功能,改善肠黏膜通透性,减少肠内菌群移位,抑制肠源性内毒素血症的发生、发展,为奥曲肽在肠源性内毒素血症患者中的应用提供新的证据支持.
目的 觀察奧麯肽持續靜脈泵入在腸源性內毒素血癥患者中的治療效果.方法 腸梗阻非手術治療患者80例,34例常規治療者設為Ⅰ組,46例常規治療聯閤奧麯肽24h持續靜脈泵入者設為Ⅱ組,于治療前和治療後24h、48 h、4d檢測白細胞計數(WBC)、二胺氧化酶(DAO)、D-乳痠(D-LA)、內毒素含量.結果 兩組治療後48h WBC、DAO、D-LA、內毒素含量均達到峰值,兩組治療後24h WBC、DAO、D-LA、內毒素含量比較差異無統計學意義(P＞0.05).Ⅱ組治療後48 h、4dWBC、DAO、D-LA、內毒素含量均低于Ⅰ組,治療後48 h比較差異有統計學意義[(18.40±0.10)×109/L比(20.60±2.36)× 109/L、(6.12±1.02)kU/L比(8.02±1.54)kU/L、(2.14±0.21) mg/L比(3.34±0.04) mg/L、(1.65±0.16) kEU/L比(2.23±0.36) kEU/L](P＜ 0.01),治療後4d比較差異無統計學意義(P＞0.05).Ⅱ組患者治療後48h體溫、胃腸減壓量、肛門排氣時間分彆為(37.60±3.01)℃、(320.00±76.14) ml/d、(54.00±0.94)h,均優于Ⅰ組的(38.50±2.21)℃、(500.00±80.32) ml/d、(68.00±1.02)h,差異有統計學意義(P＜0.01).結論 持續靜脈泵入奧麯肽能有效保護腸黏膜屏障功能,改善腸黏膜通透性,減少腸內菌群移位,抑製腸源性內毒素血癥的髮生、髮展,為奧麯肽在腸源性內毒素血癥患者中的應用提供新的證據支持.
목적 관찰오곡태지속정맥빙입재장원성내독소혈증환자중적치료효과.방법 장경조비수술치료환자80례,34례상규치료자설위Ⅰ조,46례상규치료연합오곡태24h지속정맥빙입자설위Ⅱ조,우치료전화치료후24h、48 h、4d검측백세포계수(WBC)、이알양화매(DAO)、D-유산(D-LA)、내독소함량.결과 량조치료후48h WBC、DAO、D-LA、내독소함량균체도봉치,량조치료후24h WBC、DAO、D-LA、내독소함량비교차이무통계학의의(P＞0.05).Ⅱ조치료후48 h、4dWBC、DAO、D-LA、내독소함량균저우Ⅰ조,치료후48 h비교차이유통계학의의[(18.40±0.10)×109/L비(20.60±2.36)× 109/L、(6.12±1.02)kU/L비(8.02±1.54)kU/L、(2.14±0.21) mg/L비(3.34±0.04) mg/L、(1.65±0.16) kEU/L비(2.23±0.36) kEU/L](P＜ 0.01),치료후4d비교차이무통계학의의(P＞0.05).Ⅱ조환자치료후48h체온、위장감압량、항문배기시간분별위(37.60±3.01)℃、(320.00±76.14) ml/d、(54.00±0.94)h,균우우Ⅰ조적(38.50±2.21)℃、(500.00±80.32) ml/d、(68.00±1.02)h,차이유통계학의의(P＜0.01).결론 지속정맥빙입오곡태능유효보호장점막병장공능,개선장점막통투성,감소장내균군이위,억제장원성내독소혈증적발생、발전,위오곡태재장원성내독소혈증환자중적응용제공신적증거지지.
Objective To observe the clinical effect of continuous intravenous pumping of octreotide in the treatment of intestinal endotoxemia.Methods Eighty patients with intestinal obstruction and non-surgical treatment were divided into group Ⅰ with 34 cases who received conventional-treatment and group Ⅱ with 46 cases who received conventional-treatment combined with octreotide 24 h continuous intravenous pumping.White blood cell count ( WBC ),diamine oxidase (DAO),D-lactic acid (D-LA) and endotoxin were detected before treatment and at 24 h,48 h,4 d after treatment.Results The content of WBC,DAO,D-LA and endotoxin in two groups all reached peak at 48 h after treatment.The difference of the content of WBC,DAO,D-LA and endotoxin between two groups had no statistical significance at 24 h after treatment (P ＞ 0.05).The content of WBC,DAO,D-LA and endotoxin of group Ⅱ at 48 h and 4 d after treatment were lower than those of group Ⅰ.And the difference at 48 h after treatment had statistical significance[(18.40 ±0.10)× 109/L vs.(20.60 ± 2.36) × 109/L,(6.12 ± 1.02) kU/L vs.(8.02 ± 1.54) kU/L,(2.14 ±0.21) mg/L vs.(3.34 ± 0.04) mg/L,(1.65 ±0.16) kEU/L w.(2.23 ±0.36) kEU/L] (P ＜ 0.01).While the difference at 4 d after treatment had no statistical significance(P＞ 0.05 ).Body temperature at 48 h after treatment,gastrointestinal decompression capacity,anus exhaust time of group Ⅱ were (37.60 + 3.01 )℃,(320.00 ± 76.14) ml/d,(54.00 ± 0.94) h respectively,and they all were superior to those of group Ⅰ[(38.50 ± 2.21 ) ℃,(500.00 ± 80.32) ml/d,(68.00 ± 1.02) h] (P ＜0.01).Conclusions Continuous intravenous pumping of octreotide can effectively protect the intestinal mucosal barrier function,improve intestinal permeability,reduce the trmslocation of intestinal flora,inhibit the incidence and development of enterogenous endotoxemia.And it provides new evidence to support the clinioal application of octreotide in patients with intestinal endotoxemia.
