生长抑素联合地塞米松对腹部术后早期炎性肠梗阻的疗效及对胃肠功能和血清LPS IL-6 hs-CRP的影响

doi:10.3969/j.issn.1006-6233.2018.12.014

摘要
图/表
参考文献
相关文章 (8)

全文: PDF (1377 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要 目的: 探讨生长抑素联合地塞米松对腹部术后早期炎性肠梗阻的疗效及对患者胃肠功能和血清内毒素(LPS)、白细胞介素-6(IL-6)、高敏C反应蛋白(hs-CRP)的影响。方法: 研究对象选自我院2015年5月至2017年6月收治的138例腹部术后早期炎性肠梗阻患者,依据患者的入院顺序做编号,并采用简单随机数字表分成观察组与对照组两组,每组69例。两组患者均给予常规对症支持治疗,对照组在此基础上联合给予地塞米松治疗,观察组在对照组基础上联合给予生长抑素治疗。比较两组临床疗效、胃肠功能恢复情况及治疗前后血清LPS、IL-6、hs-CRP水平变化情况。结果: 观察组治疗总有效率为91.30%(63/69),与对照组[75.36%(52/69)]相比显著上升(P<0.05)。观察组肠鸣音恢复时间、肛门排气恢复时间、腹痛腹胀缓解时间、恶心呕吐消失时间均显著短于对照组(P<0.01)。相对于治疗前,两组治疗后血清LPS、IL-6、hs-CRP水平均有明显下降(P<0.01),且治疗后观察组以上指标均明显低于对照组(P<0.01)。结论: 生长抑素联合地塞米松治疗腹部术后早期炎性肠梗阻可有效促进胃肠功能的恢复,缓解炎症反应,疗效确切。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	张瑞鹏
	戴毅
	王辉

关键词 ：生长抑素, 地塞米松, 早期炎性肠梗阻, 胃肠功能

Abstract：Objective: To investigate the clinical efficacy of somatostatin combined with dexamethasone on early postoperative inflammatory ileus after abdominal operation and its influence on patients' gastrointestinal function and their serum lipopolysaccharide (LPS), interleukin -6 (IL-6), high-sensitivity C-reactive protein (hs-CRP) levels. Methods: The subjects of this study were selected from 138 cases of patients with early postoperative inflammatory ileus after abdominal operation admitted in our hospital from May 2015 to June 2017. The patients were according to simple random number table method were divided into observation group and control group, each with 69 cases. Besides conventional treatment given to both groups, dexamethasone was adopted to the control group in addition, and combination of somatostatin and dexamethasone was given to the observation group additionally. The clinical efficacy, the recovery status of gastrointestinal function, and changes of serum LPS, IL-6, hs-CRP levels before and after treatment were compared between the two groups. Results: The overall effective rate of the observation group was 91.30% (63/69), much higher than 75.36% (52/69) of the control group (P<0.05). The time for resuming of peristaltic sound, postoperative exhausting, release of abdominal pain and distention, extinction of nausea and vomitting that the observation group took was significantly shorter than the time the control took (P<0.01). After treatment, both groups saw great decrease in serum LPS, IL-6 and hs0CRP levels as compared with those before treatment (P<0.01), and observation group had remarkably lower levels of above indicators than the control group did at the identical time points after treatment (P<0.01). Conclusion: Application of somatostatin combined with dexamethasone in treating early postoperative inflammatory ileus after abdominal operation is effective in promoting the recovery of gastrointestinal function and mitigating inflammatory reactions.

Key words： Somatostatin Dexamethasone Early postoperative inflammatory ileus Gastrointestinal function

基金资助:陕西省自然科学基金项目,(编号:2012CB239)

引用本文:

张瑞鹏,戴毅,王辉. 生长抑素联合地塞米松对腹部术后早期炎性肠梗阻的疗效及对胃肠功能和血清LPS IL-6 hs-CRP的影响[J]. 河北医学, 2018, 24(12): 1991-1994.
ZHANG Ruipeng, DAI Yi, WANG Hui. Somatostatin Combined with Dexamethasone on Early PostoperativeInflammatory Ileus after Abdominal Operation and its Influence on the Gastrointestinal Function and LPS IL-6 hs-CRP Levels in Patients. HeBei Med, 2018, 24(12): 1991-1994.

链接本文:

http://www.hbyxzzs.cn/CN/10.3969/j.issn.1006-6233.2018.12.014 或 http://www.hbyxzzs.cn/CN/Y2018/V24/I12/1991

[1] Rasslan R, Utiyama EM, Marques GM, et al. Inflammatory activity modulation by hypertonic saline and pentoxifylline in a rat model of strangulated closed loop small bowel obstruction [J]. Int Surg, 2014, 12 (6): 594~600.
[2] Stoffels B, Türler A, Schmidt J, et al. Antiinflammatory role of glycine in reducing rodent postoperative inflammatory ileus [J]. Neurogastroenterol Motil, 2011, 23 (1): 76~87.
[3] Wu Zhi-ke. Treatment for 40 Cases of Postoperative Inflammatory Ileus with Integrative Medicine [J]. Western Journal of Traditional Chinese Medicine, 2013, 26 (9): 10~12.
[4] 邵建富, 李兴海,李文,等.生长抑素对老年术后早期炎性肠梗阻患者炎性因子及胃肠功能的影响[J].重庆医学,2017,46(2):191~192.
[5] Ge Yong-kang, Yu Hua-rong, Zhou Chuan-fen. Protective effect of somatostatin on the pancreatic blood flow and pancreatic function of patients with acute pancreatitis [J]. Hainan Med, 2015, 26(3): 378~380.
[6] 罗超元.生长抑素治疗腹部手术后早期炎性肠梗阻的临床效果分析[J].中国现代手术学杂志,2014,18(3):176~178.
[7] 陈浩,汤亲青,方茂勇.生长抑素治疗术后早期炎性肠梗阻疗效的Meta分析[J].肝胆外科杂志,2015,23(6):442~447.
[8] Chen Hao, Tang Qin-qing, Fang Mao-yong. Somatostatin for early postoperative inflammatory small bowel obstruction: A meta analysis of efficacy [J]. Journal of Hepatobiliary Surgery, 2015,23 (6): 442~447.
[9] Guo Yong, Lv Yang, Sun Lu-lu, et al. Effect of somatostatin on the intestinal epithelial cell and peripheral blood lymphocyte in the acute intestinal obstruction rats [J]. Chin Crit Care Med, 2012,32(12):1113~1116.
[10] Chatzopoulou A, Heijmans JP, E Burgerhout E, et al. Glucocorticoid-Induced Attenuation of the Inflammatory Response in Zebrafish [J]. Endocrinology,2016,157 (7): 2772.
[11] Wang Xiang-feng, Yang Ri-gao, Wu Guo-qing, et al. Comparison of the effects of glucocorticoids and octreotide in treatment of early postoperative inflammatory small bowel obstruction [J]. Med West China, 2014,26(7):876~878.
[12] Mariani P, Blumberg J, Landau A, et al. Symptomatic treatment with lanreotide microparticles in inoperable bowel obstruction resulting form peritoneal carcinomatosis: a randomized, double-blind, placebo-controlled phase III study [J].Clin Oncol,2012,30(35):4337~4343.
[13] Guo Hui-ling, Shao Yu-yu, Menghebilige, et al. Research on the relation between gastrointestinal microbiota and disease [J]. Microbiology China,2015,42(2):400~410.