【摘要】 目的探讨生长抑素类似物——奥曲肽治疗胃肠道肿瘤所致恶性肠梗阻的临床效果。方法回顾性分析2006年1月～2008年2月我院42例恶性肠梗阻的临床资料,分为奥曲肽组23例和对照组19例,比较2组患者在治疗后腹痛、腹胀症状变化,肛门恢复排气排便时间,胃肠减压量,中转手术率和住院时间。结果奥曲肽组腹胀、腹痛缓解率78.3%(18/23)较常规组36.8%(7/19)有明显改善(χ2=7.409,P=0.006);奥曲肽组胃肠引流量(409.1±32.4)ml显著少于常规组(605.7±45.9)ml(t=-16.237,P=0.000);奥曲肽组中转手术率21.7%(5/23)显著低于常规组63.2%(12/19)(χ2=7.409,P=0.006);治疗后肛门开始排气时间奥曲肽组(4.1±1.3)d显著短于常规组(6.5±2.7)d(t=3.773,P=0.000);治疗后奥曲肽组生活质量明显改善,KPS评分为(61.2±7.2)分,显著高于常规组(45.1±7.8)分(t=4.910,P=0.000)。结论在常规治疗基础上加用生长抑素类似物奥曲肽能改善胃肠道肿瘤所致肠梗阻患者的临床症状,降低中转手术率,改善患者生活质量。更多还原

【Abstract】 Objective To investigate the effectiveness of somatostatin(octreotide) in the treatment of malignant bowel obstruction(MBO) due to gastrointestinal carcinoma.Methods Clinical data of 42 patients with MBO due to gastrointestinal carcinoma were retrospectively analyzed since January 2006 though February 2008.The patients were divided into two groups:control group(routine therapy,n=19) and octreotide group(n=23).Octreotide group received routine therapy combined with octreotide.The change of abdominal symptoms,gastrointestinal function recovery time,gastrointestinal drainage volume,the rate of conversion to open surgery,and hospital stay were observed and compared between the two groups. Results After the treatment,the abdominal distention and pain were relieved significantly in octreotide group compared to the control group [78.3%(18/23) vs.36.8%(7/19),χ2=7.409,P=0.006].Furthermore,the octreotide group showed significantly less gastrointestinal drainage volume,lower rate of conversion to open surgery,shorter recovery time for gastrointestinal function,and higher KPS [(409.1±32.4) ml vs.(605.7±45.9) ml,t=-16.237,P=0.000;21.7%(5/23) vs.63.2%(12/19),χ2=7.049,P=0.006;(4.1±1.3) d vs.(6.5±2.7) d,t=3.773,P=0.016;61.2±7.2 vs.45.1±7.8,t=4.910,P=0.000].Conclusions Octreotide combined with routine treatment is effective in the management of MBO.It can effectively relieve the symptoms of MBO,reduce the rate of conversion to open surgery,and improve the quality of life of patients.更多还原