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中国防痨杂志 ›› 2014, Vol. 36 ›› Issue (11): 966-969.doi: 10.3969/j.issn.1000-6621.2014.11.009

• 论著 • 上一篇    下一篇

生长抑素在治疗结核性肠梗阻中的应用研究

魏国 何永 赵勇 华欣 刘林   

  1. 610061 成都市公共卫生临床医疗中心普外科
  • 收稿日期:2014-02-08 出版日期:2014-11-10 发布日期:2014-12-05
  • 通信作者: 魏国 E-mail:weiguo69@sohu.com

Application of somatostatin in the treatment of tuberculous ileus

WEI Guo, HE Yong, ZHAO Yong, HUA Xin, LIU Lin   

  1. General Surgery Department, Public Health Clinic Center of Chengdu, Chengdu 610061, China
  • Received:2014-02-08 Online:2014-11-10 Published:2014-12-05
  • Contact: WEI Guo E-mail:weiguo69@sohu.com

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摘要： 目的 探讨生长抑素在结核性肠梗阻治疗中的应用价值及应用时限。方法 收集成都市公共卫生临床医疗中心2009年1月至2013年8月因腹腔结核性肠梗阻住院患者的资料，对42例在常规治疗（正规抗结核治疗、禁食、持续胃肠减压、维持水电解质、酸碱平衡等常规治疗）的基础上加用注射用生长抑素（思他宁）治疗（生长抑素24h持续静脉滴注）的患者进行回顾性分析；同时选取同期因腹腔结核性肠梗阻住院，未加用生长抑素治疗的患者36例，分别列入观察组和对照组。观察患者治疗前后腹痛和腹胀症状改善情况、肛门自主排气时间、X线检査所见征象恢复时间。采用SPSS 18.0统计软件进行统计学分析。计数资料的比较采用χ2检验，计量资料的比较采用t检验，P<0.05为差异有统计学意义。结果 治疗时间内观察组有效34例，占81.0%（34/42），无效8例，占19.0％（8/42）；对照组有效20例，占55.6%（20/36），无效16例，占44.4％（16/36）。观察组有效率明显高于对照组（χ2=5.870，P<0.05）。观察组加用生长抑素后腹痛和腹胀缓解时间为（3.60±1.33）d、肛门自主排气时间为（5.95±1.51）d、X线征象恢复时间为（10.40±2.64）d，与对照组比较［（4.47±1.61）d、（7.19±1.90）d、（13.36±4.29）d］，差异均有统计学意义（t=2.636，P<0.05；t=3.218，P<0.05；t=3.720，P<0.05）。观察组加用生长抑素治疗3、7、10d的有效率分别为40.5％（17/42）、59.5％（25/42）、81.0％（34/42）；患者应用生长抑素治疗3、7、10d后，新增有效率分别为40.5％（17/42）、32.0％（8/25）、52.9％（9/17），生长抑素治疗7d与生长抑素治疗3d、生长抑素治疗10d与生长抑素治疗7d比较，新增有效率差异均有统计学意义（χ2=5.536，P=0.019；χ2=13.432，P=0.000）。结论 生长抑素治疗结核性肠梗阻可取得满意的疗效；生长抑素应用时限至10d时仍能提高有效率。

关键词: 结核, 胃肠, 肠梗阻, 生长抑素

Abstract: Objective To study the applied value and duration of somatostatin in the treatment of tuberculous ileus.  Methods Seventy-eight patients with tuberculous ileus from Public Health Clinical Medical Center of Chengdu City, China from January 2009 to August 2013 were divided into 42 cases in treatment group and 36 cases in control group. The cases in control group received conventional conservative therapy combined with anti-tuberculosis (TB) therapy (Regular anti-TB treatment, fasting, continuous gastrointestinal decompression, maintain water electrolyte and acid-base balance, etc.). The cases in treatment group received somatostatin therapy on the basis of the control group (24 hours continuous intravenous infusion of somatostatin). The patients were observed the improvement of abdominal pain, abdominal distension, the time of anal independent exhaust, and X-ray changes before and after treatment.  Results In treatment group, 34 cases (81.0%, 34/42) were effective, and 8 cases (19.0%，8/42) were invalid. In control group, 20 cases (55.6%，20/36) were effective, and 16 cases (44.4%，16/36) were ineffective. The efficiency of the treatment group was significantly higher than the control group (χ2=5.870, P<0.05). Compared with conventional therapy, somatostatin therapy of treatment group significantly shortened the time of alleviating abdominal pain and distension ((3.60±1.33)d vs (4.47±1.61)d, t=2.636, P<0.05), anal independent exhaust ((5.95±1.51)d vs (7.19±1.90)d, t=3.218, P<0.05), X-ray sign recovery ((10.40±2.64)d vs (13.36±4.29)d, t=3.720, P<0.05). The effective rates of using somatostatin for 3 days, 7 days, and 10 days in treatment group were 40.5%（17/42）, 59.5%（25/42）, and 81.0%（34/42）, respectively. Three days, 7 days, and 10 days of somatostatin therapy increased 40.5%（17/42）, 32.0%（8/25）, and 52.9%（9/17）significant efficiencies, respectively. There were statistical significance among the increased efficiencies for 3 days, 7 days, and 10 days of somatostatin therapy (χ2=5.536, P=0.019; χ2=13.432, P=0.000).  Conclusion Somatostatin used in treatment of tuberculous ileus can get satisfactory curative effect. Somatostatin using 10 days can still significantly improve the efficiency.

Key words: Tuberculosis, gastrointestinal, Intestinal obstruction, Somatostatin

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