CAJ | 학술논문

目的：探讨奥曲肽联合常规药物保守治疗Ⅰ期及Ⅱ期新生儿坏死性小肠结肠炎的临床疗效。方法选择2010年8月至2014年2月医院新生儿科收治的患儿86例，按照随机数字表法分为治疗组和对照组，各43例。两组均给予常规保守治疗，治疗组加用奥曲肽微泵静脉输注，每日1次，连续7 d。观察常规实验室检查结果的变化，测定肠道特异性标志物血浆肠脂肪酸结合蛋白（I－FABP）和粪钙卫蛋白（FC）水平。结果治疗1周后，治疗组总有效率为93.02%，明显高于对照组的81.40%（ P﹤0.05）；两组患儿血尿素氮、血浆总蛋白、血浆白蛋白均较治疗前无明显变化（ P﹥0.05）；血小板计数均明显升高（ P﹤0.05），治疗组上升更明显（ P﹤0.05）；胆红素水平有所降低，但组间无明显差异；两组患者I－FABP和FC水平均较治疗前明显下降（ P﹤0.05），且治疗组下降更明显（ P﹤0.05）；两组患者治疗前后血常规、尿常规、肝肾功能及心电图变化均在可接受范围内，且未见高血糖、胆石、糖耐受异常、胆汁淤积性并发症等其他不良反应。结论奥曲肽联合常规保守治疗Ⅰ期及Ⅱ期新生儿坏死性小肠结肠炎的疗效较传统保守治疗更可靠，且无明显不良反应，值得推广。
목적：탐토오곡태연합상규약물보수치료Ⅰ기급Ⅱ기신생인배사성소장결장염적림상료효。방법선택2010년8월지2014년2월의원신생인과수치적환인86례，안조수궤수자표법분위치료조화대조조，각43례。량조균급여상규보수치료，치료조가용오곡태미빙정맥수주，매일1차，련속7 d。관찰상규실험실검사결과적변화，측정장도특이성표지물혈장장지방산결합단백（I－FABP）화분개위단백（FC）수평。결과치료1주후，치료조총유효솔위93.02%，명현고우대조조적81.40%（ P﹤0.05）；량조환인혈뇨소담、혈장총단백、혈장백단백균교치료전무명현변화（ P﹥0.05）；혈소판계수균명현승고（ P﹤0.05），치료조상승경명현（ P﹤0.05）；담홍소수평유소강저，단조간무명현차이；량조환자I－FABP화FC수평균교치료전명현하강（ P﹤0.05），차치료조하강경명현（ P﹤0.05）；량조환자치료전후혈상규、뇨상규、간신공능급심전도변화균재가접수범위내，차미견고혈당、담석、당내수이상、담즙어적성병발증등기타불량반응。결론오곡태연합상규보수치료Ⅰ기급Ⅱ기신생인배사성소장결장염적료효교전통보수치료경가고，차무명현불량반응，치득추엄。
Objective To investigate the clinical efficacy of octreotide combined with conventional conservative therapy in treating phaseⅠ,Ⅱ neonatal necrotizing enterocolitis(NEC). Methods 86 patients with phase Ⅰ,Ⅱ of neonatal NEC admitted to our hospital from August 2010 to February 2014 were selected and divided into the treatment group and the control group according to the random num-ber table,43 cases in each group. The two groups were given the conventional conservative treatment. The treatment group was added with octreotide by intravenous moicropump infusion,once a day,for 7 d. The changes of blood,urine,fecal occult blood,liver and kidney function and ECG were observed. The intestinal specific marker plasma intestinal fatty acid binding protein(I-FABP) and fecal cal-protectin(FC)levels were detected. Results The total effective rate after 1-week treatment in the treatment group was 93. 02%,which was significantly higher than 81. 40% in the control group( P ﹤ 0. 05);the blood urea nitrogen,plasma total protein and albumin in the two groups had no obvious change compared with before treatment( P ﹥ 0. 05),the platelet in the two groups was significantly higher than before treatment,the treatment group was more nigher ( P ﹤ 0. 05 ) ,the bilirubin level was decreased to some extent( P ﹤ 0. 05), but no significant difference betueen the two groups;plasma I-FABP and FC were significantly decreased compared with before treat-ment( P ﹤ 0. 05),moreover the decrease in the treatment group was more significant than the control group( P ﹤ 0. 05);the blood rou-tine,urine routine,liver and kidney functions and ECG changes in the two groups were within the acceptable ranges without the compli-cations of hyperglycemia,cholelithiasis,abnormal glucose tolerance,cholestatic and other adverse reactions. Conclusion The efficacy of octreotide combined with conventional conservative therapy in treating phase Ⅰ,Ⅱneonatal NEC is more reliable without significant ad-verse reactions than the traditional conservative treatment,which is worthy of promotion.