【作者】 周勇；

【导师】 伍晓汀；

【作者基本信息】 四川大学 ， 外科学， 2004， 硕士

【摘要】 目的 探讨生长激素用于胃肠道术后的临床效果和安全性。 方法 采用前瞻性、随机、单盲、对照设计。胃肠道中等以上手术患者48例,随机分为试验组或对照组,每组24人,从术后第3～9天,试验组给予生长激素0.15 IU·kg^-1·d^-1,对照组给予安慰剂-溶媒,其余治疗相同。临床疗效指标:生命体征、血常规、血生化、术后住院时间、术后住院费用、体重;耐受性指标:血糖和尿糖水平、胰岛素用量以及并发症的发生情况。 结果 术后住院费用试验组较对照组低（治疗组:3366.67±541.07;对照组:3911.67±581.72）,差异有统计学意义（P<0.05）和临床意义。试验组术后第4～7天血糖较对照组高（治疗组:术后第4天:8.33±3.91,术后第5天:8.95±4.52,术后第6天:8.11±2.87,术后第7天:7.34±3.11;对照组:术后第4天:5.76±1.57,术后第5天:6.18±2.27,术后第6天:6.32±2.97,术后第7天:5.87±2.38）,差异有统计学意义（P<0.05）和临床意义。试验组术后第5天24小时尿糖定量较对照组高（治疗组:术后第5天:22.23±27.23;对照组:术后第5天:10.75±18.69）,差异有统计学意义（P<0.05）和临床意义。试验组23例高血糖中有5例需更多还原

【Abstract】 Objective To explore the clinical effectiveness and safety of recombinanthuman growth hormone （rhGH） in patients undergoing gastrointestinalsurgery.Methods The study was designed as a randomized prospective single-blindclinical controlled trial. 48 patients after elective gastrointestinal surgerywere randomly allocated to receive either rhGH (0.15 IU ·kg^-1 ·d^-1) or placebofrom 3rd to 9th day after surgery. A series parameters were measured,including vital signs, blood cell count, renal and liver functions, electrolytes,length of hospital stay, cost of hospitalization, body weight, blood glucoseand urine glucose of 24 hours. Complications and the use of insulin wererecorded.Results In the rhGH treated group, cost of hospitalization was decreasedwith statistical significance. Blood glucose was elevated with statisticalsignificance in the rhGH group from 4th to 7th day after surgery. Urineglucose of 24 hours was also elevated with statistical significance in the rhGH group at 5th day after surgery. 5 of 23 patients with hyperglycemia in the rhGH group needed more insuline to control blood glucose, and 3 of 4 patients in the placebo group. There were three patients had other complications in the rhGH group, which were one mild edema, one tetter and one fever. There was no statistical significance between two groups in vital signs, blood cell count, renal and liver functions, electrolytes, length of hospital stay and body weight.Conclusions Postoperative rhGH treatment of patients undergoing gastrointestinal surgery was safe and effective. It could reduce cost of hospitalization. Although rhGH might elevate blood glucose and urine glucose, at most time this complication did not need to be treated with low dose insulin. Fluid retention and tetter was mild and uncommon in a short-term treatment.更多还原