CAJ | 학술논문

目的：探讨奥曲肽用于治疗腹部手术后早期炎性肠梗阻的疗效及对患者血清内毒素(LPS)和超敏C反应蛋白(hs-CRP)水平的影响。方法选取腹部手术后早期炎性肠梗阻患者64例，随机分为观察组(n=32)和对照组(n=32)。两组均予以常规治疗，包括禁食、持续胃肠减压、抗感染、静脉营养、维持水电解质和酸碱平衡等。观察组加用奥曲肽针0.1 mg皮下注射，q8h。对照组除不使用奥曲肽针余治疗同观察组。观察两组患者治疗前和治疗6 d后血清LPS和hs-CRP水平的变化，并比较其疗效及不良反应。结果治疗6 d后，两组患者血清LPS和hs-CRP水平较前均有不同程度下降(P<0.05或P<0.01)，且观察组下降值较对照组更明显(P<0.05)；同时观察组临床总有效率(93.75%)明显优于对照组(75.00%)(字2=4.27，P<0.05)；治疗中不良反应对照组和观察组分别为1例和3例，症状均较轻，两组比较差异无统计学意义(字2=0.27，P>0.05)。结论奥曲肽用于治疗腹部手术后早期炎性肠梗阻的疗效较显著，安全性亦较好，这与其能明显降低患者血清LPS和hs-CRP水平的作用机制密切相关。
목적：탐토오곡태용우치료복부수술후조기염성장경조적료효급대환자혈청내독소(LPS)화초민C반응단백(hs-CRP)수평적영향。방법선취복부수술후조기염성장경조환자64례，수궤분위관찰조(n=32)화대조조(n=32)。량조균여이상규치료，포괄금식、지속위장감압、항감염、정맥영양、유지수전해질화산감평형등。관찰조가용오곡태침0.1 mg피하주사，q8h。대조조제불사용오곡태침여치료동관찰조。관찰량조환자치료전화치료6 d후혈청LPS화hs-CRP수평적변화，병비교기료효급불량반응。결과치료6 d후，량조환자혈청LPS화hs-CRP수평교전균유불동정도하강(P<0.05혹P<0.01)，차관찰조하강치교대조조경명현(P<0.05)；동시관찰조림상총유효솔(93.75%)명현우우대조조(75.00%)(자2=4.27，P<0.05)；치료중불량반응대조조화관찰조분별위1례화3례，증상균교경，량조비교차이무통계학의의(자2=0.27，P>0.05)。결론오곡태용우치료복부수술후조기염성장경조적료효교현저，안전성역교호，저여기능명현강저환자혈청LPS화hs-CRP수평적작용궤제밀절상관。
Objective To discuss curative effect of Octreotide on early inflammatory intestinal obstruction after abdomi-nal operation and its influence on serum LPS and High sensitive C-reactive protein (hs-CRP) levels. Methods All 64 cases of patients with early inflammatory intestinal obstruction after abdominal operation were selected and divided into observation group (n=32) and control group (n=32) at random. The patients in two groups were given routine medical treatment, such like fasting, instant gastrointestinal decompression, anti-infection, intravenous nutrition,maintenance of water-electrolyte and acid-base balance and etc. The patients in observation group were additionally given 0.1mg Octreotide by hypodermic injection,q8h,while the patients in control group were given the same medical treatment as that in observation group except for Octreotide. The changes of serum LPS and hs-CRP levels of patients in two groups before and 6 days after the medical treatment,and the curative effect and untoward effect was compared as well. Results After 6 days' medical treatment, serum LPS and hs-CRP levels of patients in two groups were obvi-ously declined than before(P<0.05 or P<0.01),and the declining rate of patients in observation group was much higher than that in control group (P<0.05), and the total clinical efficiency in observation group (93.75%) was much higher than that in control group (75.00%)(χ2=4.27,P<0.05). 1 and 3 cases of untoward effect were appeared on patients in control group and observation group during treatment with light symptom, and after comparing the occurrence rates of untoward effect of patients in two groups,no differences were appeared(χ2=0.27,P>0.05). Conclusion Octreotide has reliable curative effect on early inflammatory intestinal obstruction after abdominal operation with high security, whose mechanism of action has close effect on obvious reducing serum LPS and hs-CRP levels of patients.