小肠减压、肠外营养、生长抑素联合应用治疗单纯性肠梗阻  

Ileus tube combined with parenteral nutrition and somatostatin in treatment of intestinal obstruction

作　　者：刘牧林[1] 张雷[2] 方先业[1] 鲍子雨[3] 

机构地区：[1]蚌埠医学院附属医院胃肠外科,安徽蚌埠233004 [2]上海华瑞制药有限公司医学部,200025 [3]安徽省蚌埠市第一人民医院,233000

出　　处：《蚌埠医学院学报》2004年第3期216-218,共3页Journal of Bengbu Medical College

基　　金：安徽省教育厅自然科学研究资助项目 ( 96JL0 13 )

摘　　要：目的 :探讨联合应用小肠减压导管、肠外营养支持、生长抑素治疗单纯性肠梗阻的效果。方法 :6 4例肠梗阻患者随机分为 3组 ,分别予以小肠减压 (A组 )、小肠减压 +营养支持 (B组 )、小肠减压 +营养支持 +生长抑素 (C组 ) ,治疗时间 7～1 4天 ,并定期评定其腹痛消失时间、肛门排气时间、气液平面消失时间和梗阻解除时间 ,小肠减压导管引流量和患者血浆前白蛋白亚油酸和氮平衡等营养状况。结果 :3组患者梗阻解除率为 85 .0 %、85 .7%和 91 .3% (P >0 .0 5 ) ,第 1 5天B、C两组前白蛋白值为 (30 1 .32± 72 .5 8)mg/L、(32 8.39± 6 4 .1 9)mg/L ,亚油酸值为 (6 6 .72± 2 0 .5 4 ) μmol/L、(5 8.88± 2 4 .6 3) μmol/L ,氮平衡值为 (1 .5± 1 .1 ) g/L、(1 .8± 1 .4 ) g/L ,均明显大于A组 (P <0 .0 1 ) ,C组导管引流量第 2天起明显减少 ,腹痛消失时间为(5 0 .2 8± 2 4 .37)h ,肛门排气时间为 (6 9.4 9± 37.30 )h ,气液平消失时间为 (77.2 4± 38.1 0 )h ,C组梗阻解除时间较A、B两组有所缩短 (P <0 .0 5 )。结论 :联合应用小肠减压导管、营养支持、生长抑素缩短肠梗阻解除时间 ,改善患者营养状况 。Objective:To evaluate the effect of ileus tube,parenteral nutrition and octreotide combined in treatment of patients with intestinal obstruction.Methods:Sixty four patients were randomly divided into three groups:group A were treated with ileus tube,group B with ileus tube and parenteral nutrition and group C with ileus tube,parenteral nutrition and octreotide.The therapy lasted for 7 to 14 days.Results:The ileus removing rates were 85.0%(A),85.7%(B) and 91.3%(C) respectively,in the three groups( P >0.05).On the 15th day,the serum pro albumin was(217.51±56.32)g/ml(A),(301.32±72.58)g/ml(B) and (328.39±64.19)g/ml(C)( P <0.01).The serum essential fatty acid was(31.98±19.91)μmol/L(A),(66.72±20.54)μmol/L(B) and (58.88±24.63)μmol/L(C)( P <0.01).In C group,the ceasing time of the abdomen pain was (50.28±24.37)hours,the time of the fecal passage was (65.49±37.30)hours,the disappearing time of the stepladder distribution of distended small bowel loops in the radiologic film was (77.24±38.10)hours( P <0.01),the volume of stomach and intestinal suction was lower than that in other groups.Conclusions:The results show that application of ileus tube combined with parenteral nutrition and somatostatin can improve the nutritious condition of the patients and increase the cure rate.

关 键 词：肠梗阻 肠外营养 小肠减压 生长抑素 

分 类 号：R574.2[医药卫生—消化系统]