中华普通外科杂志
中華普通外科雜誌
중화보통외과잡지
CHINESE JOURNAL OF GENERAL SURGERY
2011年
12期
998-1001
,共4页
曹雪源%王超%连国栋%王权
曹雪源%王超%連國棟%王權
조설원%왕초%련국동%왕권
肠梗阻%生长抑素%减压%导管插入术
腸梗阻%生長抑素%減壓%導管插入術
장경조%생장억소%감압%도관삽입술
Intestinal obstruction%Somatostatin%Decompression%Catheterization
目的 探讨生长抑素联合肠梗阻导管在粘连性肠梗阻非手术治疗中的应用价值.方法 将91例粘连性肠梗阻患者按入院顺序随机分为A组(生长抑素+肠梗阻导管组),B组(生长抑素+鼻胃管减压组),C组(肠梗阻导管组)和D组(鼻胃管组).常规治疗包括禁食、纠正水电解质和酸碱平衡紊乱,全胃肠外营养以及应用抗生素.A组在常规治疗基础上应用生长抑素类似物(善宁)0.6 mg加入0.9％氯化钠溶液500 ml持续静脉滴注,同时联合置入肠梗阻导管取代普通鼻胃管行肠内减压.观察和比较4组治疗前后临床症状及体征改善情况、胃肠减压量、自主排气、排便时间和中转手术率.数据分别采用方差分析和x2检验进行分析.结果 各组平均腹痛和腹胀的缓解时间分别为3.6±1.5,5.3±1.8,5.8±1.7和8.4±2.2d (F=28.715,P=0.000)；恢复排气、排便时间分别为4.5±1.9,5.7±1.4,6.0±1.1和7.8±1.7 d(F=23.857,P=0.000)；A组临床症状明显改善.平均胃肠减压量分别为A组:632±102 ml/d；B组:410±86 ml/d,C组:1020±148 ml/d和D组590±97 ml/d.在C组,患者的胃肠减压量明显增加(F值分别为17.367,16.347,P=0.000),而A组则明显减少(F值分别为11.687,10.399,P=0.000).4组中转手术率分别为0(0/22),10％ (2/19),9％( 3/23)和22％ (6/27),A组中转手术率明显低于D组(x2=5.571,P=0.018).结论在常规治疗的基础上,应用生长抑素静脉持续泵入联合肠梗阻导管治疗,可加速改善粘连性肠梗阻患者的临床症状,并且提高保守治疗的成功率.
目的 探討生長抑素聯閤腸梗阻導管在粘連性腸梗阻非手術治療中的應用價值.方法 將91例粘連性腸梗阻患者按入院順序隨機分為A組(生長抑素+腸梗阻導管組),B組(生長抑素+鼻胃管減壓組),C組(腸梗阻導管組)和D組(鼻胃管組).常規治療包括禁食、糾正水電解質和痠堿平衡紊亂,全胃腸外營養以及應用抗生素.A組在常規治療基礎上應用生長抑素類似物(善寧)0.6 mg加入0.9％氯化鈉溶液500 ml持續靜脈滴註,同時聯閤置入腸梗阻導管取代普通鼻胃管行腸內減壓.觀察和比較4組治療前後臨床癥狀及體徵改善情況、胃腸減壓量、自主排氣、排便時間和中轉手術率.數據分彆採用方差分析和x2檢驗進行分析.結果 各組平均腹痛和腹脹的緩解時間分彆為3.6±1.5,5.3±1.8,5.8±1.7和8.4±2.2d (F=28.715,P=0.000)；恢複排氣、排便時間分彆為4.5±1.9,5.7±1.4,6.0±1.1和7.8±1.7 d(F=23.857,P=0.000)；A組臨床癥狀明顯改善.平均胃腸減壓量分彆為A組:632±102 ml/d；B組:410±86 ml/d,C組:1020±148 ml/d和D組590±97 ml/d.在C組,患者的胃腸減壓量明顯增加(F值分彆為17.367,16.347,P=0.000),而A組則明顯減少(F值分彆為11.687,10.399,P=0.000).4組中轉手術率分彆為0(0/22),10％ (2/19),9％( 3/23)和22％ (6/27),A組中轉手術率明顯低于D組(x2=5.571,P=0.018).結論在常規治療的基礎上,應用生長抑素靜脈持續泵入聯閤腸梗阻導管治療,可加速改善粘連性腸梗阻患者的臨床癥狀,併且提高保守治療的成功率.
목적 탐토생장억소연합장경조도관재점련성장경조비수술치료중적응용개치.방법 장91례점련성장경조환자안입원순서수궤분위A조(생장억소+장경조도관조),B조(생장억소+비위관감압조),C조(장경조도관조)화D조(비위관조).상규치료포괄금식、규정수전해질화산감평형문란,전위장외영양이급응용항생소.A조재상규치료기출상응용생장억소유사물(선저)0.6 mg가입0.9％록화납용액500 ml지속정맥적주,동시연합치입장경조도관취대보통비위관행장내감압.관찰화비교4조치료전후림상증상급체정개선정황、위장감압량、자주배기、배편시간화중전수술솔.수거분별채용방차분석화x2검험진행분석.결과 각조평균복통화복창적완해시간분별위3.6±1.5,5.3±1.8,5.8±1.7화8.4±2.2d (F=28.715,P=0.000)；회복배기、배편시간분별위4.5±1.9,5.7±1.4,6.0±1.1화7.8±1.7 d(F=23.857,P=0.000)；A조림상증상명현개선.평균위장감압량분별위A조:632±102 ml/d；B조:410±86 ml/d,C조:1020±148 ml/d화D조590±97 ml/d.재C조,환자적위장감압량명현증가(F치분별위17.367,16.347,P=0.000),이A조칙명현감소(F치분별위11.687,10.399,P=0.000).4조중전수술솔분별위0(0/22),10％ (2/19),9％( 3/23)화22％ (6/27),A조중전수술솔명현저우D조(x2=5.571,P=0.018).결론재상규치료적기출상,응용생장억소정맥지속빙입연합장경조도관치료,가가속개선점련성장경조환자적림상증상,병차제고보수치료적성공솔.
Objective To evaluate the efficacy and safety of somatostatin and ileus tube for adhesive bowel obstruction.Methods From January 2008 to February 2010,ninety-one patients diagnosed with adhesive bowel obstruction were enrolled in the study.Patients were randomly divided into four groups:somatostatin + ileus tube group ( group A,n =22 ),somatostatin + nasogastric tube group (group B,n=19),ileus tube group (group C,n=23),and nasogastric tube group (group D,n =27).All cases received conventional treatment,including fasting,maintaining electrolyte and acid-base balance,enteral and parenteral nutrition support and antibiotics; Groups A and B received somatostatin 0.6 mg/day,groups B and D received nasogastric tube decompression.ANOVA analysis and x2 test were used to compare the variables.Results Group A had a quick recovery of flatus and stool compared with group D,[ (4.5 ±1.9) vs.(7.8 ± 1.7) d] (F =28.715,P =0.000).Abdominal pain and abdominal distension recovered faster [ (3.6 ± 1.5) vs.(8.4 ± 2.2) day ] in group A compared with group D ( F =23.857,P =0.000).Less amount of gastric drainage were observed in somatostatin-treatment groups [ group A vs.C:(632 ±102) ml/d vs.(1020±148) ml/d; group B vs.D:(410±86) ml/d vs.(590±97) ml/d] (F=11.687,P =0.000;F=10.399,P =0.000).The rate of laparotomy in group A was O,which was significantly less than the 22％ in group D ( x2 =5.571,P =0.018 ).Conclusions The high improvement rate in abdominal symptoms suggested the efficacy of somatostatin and ileus tube in patients with small bowel obstruction.The application of somatostatin combined with ileus tube improves the symptoms of adhesive intestinal obstruction and decreases the rate of laparotomy.
