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目的观察奥曲肽治疗恶性肠梗阻术后早期炎症的临床疗效及安全性。方法将68例术后早期炎性肠梗阻患者随机分为对照组34例和试验组34例。对照组第1周给予静脉注射地塞米松5 mg,q8 h,1周后逐渐停药;试验组在对照组的基础上,给予皮下注射奥曲肽注射液0.1 mg,q8 h,直至胃肠排气、排便等功能恢复正常或中转手术治疗才予以停药。比较2组患者的临床疗效、体征改善时间、辅助检查的改善情况,以及不良反应发生率。结果治疗后,试验组的总有效率94.12%显著高于对照组64.71%(P<0.05)。治疗后,试验组的腹胀、腹痛、恶心、呕吐及肛门排气排便等临床症状体征改善时间均明显短于对照组(P<0.05)。治疗后,2组患者的胃肠减压量和C反应蛋白均较治疗前降低,且试验组的降低程度明显优于对照组,同时试验组纠正水电解质及酸碱失衡时间及X线片检查示恢复正常时间均明显低于对照组(P<0.05)。2组患者治疗过程中未发现严重的不良反应。结论奥曲肽治疗恶性肠梗阻术后早期炎症的临床疗效确切,无明显不良反应。
Objective To observe the clinical efficacy and safety of octreotide in the treatment of early postoperative inflammation of malignant intestinal obstruction. Methods Sixty-eight patients with early postoperative inflammatory bowel obstruction were randomly divided into control group (34 cases) and experimental group (34 cases). The control group was given intravenous dexamethasone 5 mg q8 h on the first week, and gradually stopped after one week. On the basis of the control group, subcutaneous injection of octreotide 0.1 mg q8 h was given subcutaneously in the test group until the gastrointestinal exhaust , Defecation and other functions returned to normal or transit surgery was discontinued. The clinical efficacy, improvement of signs, the improvement of auxiliary examinations, and the incidence of adverse reactions were compared between the two groups. Results After treatment, the total effective rate 94.12% in the experimental group was significantly higher than that in the control group 64.71% (P <0.05). After treatment, the clinical symptoms and signs of bloating, abdominal pain, nausea, vomiting and anal defecation in the experimental group were significantly shorter than those in the control group (P <0.05). After treatment, the gastrointestinal decompression volume and C-reactive protein in both groups were lower than those before treatment, and the degree of reduction in the experimental group was significantly better than that in the control group. At the same time, the experimental group corrected the time of water and electrolyte, acid-base imbalance and X-ray examination Showed normal recovery time were significantly lower than the control group (P <0.05). No serious adverse reactions were found during treatment in the two groups. Conclusion The clinical efficacy of octreotide in the treatment of malignant intestinal obstruction is accurate and has no obvious adverse reactions.