目的 探讨生长抑素联合丙氨酰谷氨酰胺在急性粘连性肠梗阻患者中的应用效果.方法 将85例急性粘连性肠梗阻患者按随机数字表法分为对照组40例和观察组45例.对照组予以常规内科治疗,包括禁食水,持续胃肠减压,肥皂水低压灌肠,纠正水电解质及酸碱平衡紊乱,胃肠外营养支持,抗生素预防感染等;观察组除常规内科治疗外,联合应用生长抑素与丙氨酰谷氨酰胺治疗.比较2组治疗后腹痛腹胀缓解时间、肛门排气排便时间、禁食时间及中转手术治疗率,观察2组治疗后第24、48 h白细胞计数、血清降钙素原与内毒素水平及腹腔压力的变化.结果 观察组治疗后腹痛腹胀缓解时间、肛门排气排便时间、禁食时间均较对照组显著缩短(P<0.05),中转手术治疗率较对照组显著减少(P<0.05).观察组治疗后第24、48 h白细胞计数、血清降钙素原与内毒素水平及腹腔压力均较对照组明显降低(P<0.05).结论 生长抑素联合丙氨酰谷氨酰胺对于急性粘连性肠梗阻疗效显著,安全可靠.其作用机制可能与其能减少消化液的分泌、并可保护胃肠道黏膜屏障受损及有利于促进胃肠道黏膜屏障的修复有关.%Objective To investigate the efficacy of somatostatin combined with glutamine dipeptide in acute adhesive bowel obstruction.Methods Eighty-five patients with acute adhesive bowel obstruction were randomly divided into two groups.The control group(n=40)was given conventional medical treatment,including fasting,continuous gastrointestinal decompression,low pressure bowel irrigation with soapy water,correction of electrolyte and acid-base imbalance,par-enteral nutritional support,and infection prevention with antibiotics.On the basis of conventional treatment,the observation group(n=45)was treated with somatostatin and glutamine dipeptide. The abdominal pain and distention remission time,anus exhaust and defecation time,fasting dura-tion,and surgery rate were compared between the two groups.In addition,white blood cell count, serum procalcitonin and endotoxin levels,and intra-abdominal pressure were measured at 24 and 48 hours after treatment.Results Compared with control group after treatment,the abdominal pain and distention remission time,anus exhaust and defecation time,fasting duration,surgery rate significantly decreased in observation group(P<0.05).Compared with control group at 24 and 48 hours after treatment,white blood cell count,serum procalcitonin and endotoxin levels,andintra-abdominal pressure significantly decreased in observation group(P <0.05).Conclusion The combined treatment with somatostatin and glutamine dipeptidein is effective and safe for acute adhesivebowel obstruction.The mechanism may be involved in reducing the secretion of digestive juice,protectingagainst gastrointestinal mucosal damage and promoting gastrointestinal mucosal repair.
展开▼
