生长抑素联合红霉素对腹部损伤患者术后胃肠功能、免疫及炎症因子的影响  

Effects of somatostatin combined with erythromycin on gastrointestinal function,immunity and inflammatory factors in patients with abdominal injury after operation

作　　者：李曰平 凌宗准 田晓卫[3] 李德辉[4] Yue-ping Li;Zong-zhun Ling;Xiao-wei Tian;De-hui Li(Department of Gastrointestinal Surgery,Qingdao Central Hospital,Qingdao,Shandong 266042,China;Department of Emergency Surgery,Qingdao Municipal Hospital,Qingdao,Shandong 266199,China;Department of General Surgery,Qingdao Municipal Hospital,Qingdao,Shandong 266199,China;Department of Colorectal Surgery,Qingdao Municipal Hospital,Qingdao,Shandong 266199,China)

机构地区：[1]青岛市中心医院胃肠外科,山东青岛266042 [2]青岛市市立医院急诊外科,山东青岛266199 [3]青岛市市立医院普外一科,山东青岛266199 [4]青岛市市立医院结直肠外科,山东青岛266199

出　　处：《中国现代医学杂志》2020年第17期62-66,共5页China Journal of Modern Medicine

摘　　要：目的探究生长抑素联合红霉素对腹部损伤患者术后胃肠功能、免疫及炎症因子的影响。方法选取2018年9月—2019年3月于青岛市中心医院胃肠外科手术治疗腹部损伤的患者150例,随机分为对照组(术后常规对症治疗)、单药组(对照组基础上加红霉素)和联合组(单药组基础上加生长抑素),每组50例。观察各组胃肠功能恢复情况,记录各组术后第1、3及5天胃肠减压管引流量变化,检测术前、术后第1和5天血清免疫因子(IgM、IgG、IgA)和炎症因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子α(TNF-α)]水平。结果3组肠鸣音恢复时间、首次肛门排气时间、首次排便时间、住院时间比较,差异有统计学意义(P<0.05)。联合组最短,对照组最长,单药组介于中间。术后第1、3及5天的胃肠减压管引流量比较,不同时间点的胃肠减压管引流量有差异(P<0.05);3组间胃肠减压管引流量有差异(P<0.05);3组胃肠减压管引流量变化趋势有差异(P<0.05)。术前、术后第1和5天3组IgM、IgG、IgA比较,不同时间点IgM、IgG、IgA有差异(P<0.05);3组间IgM、IgG、IgA有差异(P<0.05);3组IgM、IgG、IgA变化趋势有差异(P<0.05)。术前、术后第1及5天3组IL-6、IL-8、TNF-α比较,不同时间点IL-6、IL-8、TNF-α有差异(P<0.05);3组间IL-6、IL-8、TNF-α有差异(P<0.05);3组IL-6、IL-8、TNF-α变化趋势有差异(P<0.05)。联合组、单药组和对照组术后肠道相关并发症发生率分别为8.0%、22.0%和34.0%,3组比较,差异有统计学意义(P<0.05),联合组最低,对照组最高。结论生长抑素联合红霉素用于腹部损伤术后,可促进肠道功能和免疫功能恢复,同时抑制血清炎症因子水平,对腹腔感染和肠麻痹的防治具有重要价值。Objective To investigate the effects of somatostatin combined with erythromycin on postoperative gastrointestinal function,immunity and inflammatory factors in patients with abdominal injury.Methods Totally 150 patients with abdominal injury treated by gastrointestinal surgery in Qingdao Central Hospital from September 2018 to March 2019 were randomly divided into control group(routine symptomatic treatment after operation)and single drug group(routine symptomatic treatment+erythromycin)and the combination group(conventional symptom+somatostatin+erythromycin),50 cases in each group,to observe the recovery of gastrointestinal function in each group and record the gastrointestinal decompression drainage on the 1st,3rd,5th postoperative group.The levels of serum immune factors(IgM,IgA,IgG)and inflammatory factors(IL-6,IL-8,TNF-α)were measured before and 1 day after surgery and 5 days after surgery.Results Compared with the three groups of bowel sound recovery time,the first anal exhaust time,defecation time and hospitalization time among 3 groups,the combined group was the shortest,the control group was the longest(P<0.05).The difference was statistically significant(P<0.05).On the 1st,3rd,and 5th postoperative day,the gastrointestinal decompression tube drainage was compared,and the variance analysis of repeated measures was used.There was a difference in the gastrointestinal decompression tube drainage at different time points(P<0.05);there were differences in the drainage volume of the three groups of gastrointestinal decompression tubes(P<0.05);the change trends of gastrointestinal decompression tube drainage in 3 groups were statistically different(P<0.05).The comparison of IgM,IgA,and IgG on the 1st and 5th day after operation was compared.The variance analysis of repeated measurement data showed that:there were differences between different time points(P<0.05),among 3 groups(P<0.05),and in the trends of IgM,IgA,and IgG levels(P<0.05).There were significant differences in IL-6,IL-8 and TNF-αamong the three g

关 键 词：腹部损伤 生长抑素 红霉素 胃肠功能 炎症因子 

分 类 号：R656[医药卫生—外科学]