经鼻导管减压术联合奥曲肽治疗急性肠梗阻的效果及对血清VIP、MDA水平的影响
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摘要
目的探讨分析经鼻导管减压术联合奥曲肽对急性肠梗阻的治疗效果及对血清血管活性肠肽(VIP)、丙二醛(MDA)水平的影响。方法选择2016年11月—2018年11月本院收治的102例急性肠梗阻患者作为研究对象,随机分为对照组和观察组两组,每组各50例。两组患者均进行经鼻小肠减压管置入术治疗,观察组患者在此基础上给予奥曲肽静脉滴注治疗,对两组患者治疗效果进行比较,同时比较两组患者治疗后腹痛缓解时间、胃肠减压量和肛门排气时间,比较两组患者治疗前后血清VIP、MDA水平,记录比较两组不良反应发生情况。结果观察组有效率(92.2%)显著高于对照组(80.4%),差异具有统计学意义(P<0.05);观察组24 h胃肠减压量显著低于对照组,腹痛缓解时间和肛门排气时间显著短于对照组,差异具有统计学意义(P<0.05);治疗后,两组血清VIP和MDA水平均显著降低,且观察组两指标显著低于对照组,差异具有统计学意义(P<0.05);两组不良反应发生率相近,差异无统计学意义(P>0.05)。结论经鼻导管减压术联合奥曲肽治疗急性肠梗阻效果显著,能明显降低胃肠减压量,缩短腹痛时间和肛门排气时间,同时安全性较高,推测与奥曲肽降低患者血清VIP和MDA水平关系密切,值得在临床进一步应用。
Objective To investigate the therapeutic effect of transnasal catheter decompression combined with octreotide on acute intestinal obstruction and its effect on serum levels of vasoactive intestinal peptide( VIP) and malondialdehyde( MDA). Methods A total of 102 patients with acute intestinal obstruction admitted to our hospital from November 2016 to November 2018 were randomly divided into the control group( n =50) and the observation group( n = 50).Both groups were underwent nasogastric decompression tube for treatment.The observation group was given octreotide intravenous infusion on the basis of decompression tube treatment.The treatment effects of the two groups were compared.The time of abdominal pain relief after treatment,gastrointestinal decompression and anal sputum were compared between the two groups.The VIP and MDA levels of the two groups were compared before and after treatment. The incidence of adverse reactions in the two groups was recorded.Results The effective rate of the observation group( 92.2%) was significantly higher than that of the control group( 80.4%),P<0.05.The gastrointestinal decompression volume of the observation group was significantly lower than that of the control group( P<0.05).The abdominal pain relief time and anal exhaust time were significantly shorter than the control group( P<0.05).The serum VIP and MDA levels in the two groups were significantly decreased after treatment,and the two indexes in the observation group were significantly lower than the control group( P<0.05). The incidence of adverse reactions was similar in the two groups,and the difference was not statistically significant( P>0.05).Conclusions Transnasal catheter decompression combined with octreotide is effective in the treatment of acute intestinal obstruction,which could significantly reduce gastrointestinal decompression,shorten abdominal pain time and anal exhaust time,and has higher safety. It is speculated that the efficacy is closely related to the reduction of serum VIP and MDA levels by octreotide.It is worth further application in the clinic.
Objective To investigate the therapeutic effect of transnasal catheter decompression combined with octreotide on acute intestinal obstruction and its effect on serum levels of vasoactive intestinal peptide( VIP) and malondialdehyde( MDA). Methods A total of 102 patients with acute intestinal obstruction admitted to our hospital from November 2016 to November 2018 were randomly divided into the control group( n =50) and the observation group( n = 50).Both groups were underwent nasogastric decompression tube for treatment.The observation group was given octreotide intravenous infusion on the basis of decompression tube treatment.The treatment effects of the two groups were compared.The time of abdominal pain relief after treatment,gastrointestinal decompression and anal sputum were compared between the two groups.The VIP and MDA levels of the two groups were compared before and after treatment. The incidence of adverse reactions in the two groups was recorded.Results The effective rate of the observation group( 92.2%) was significantly higher than that of the control group( 80.4%),P<0.05.The gastrointestinal decompression volume of the observation group was significantly lower than that of the control group( P<0.05).The abdominal pain relief time and anal exhaust time were significantly shorter than the control group( P<0.05).The serum VIP and MDA levels in the two groups were significantly decreased after treatment,and the two indexes in the observation group were significantly lower than the control group( P<0.05). The incidence of adverse reactions was similar in the two groups,and the difference was not statistically significant( P>0.05).Conclusions Transnasal catheter decompression combined with octreotide is effective in the treatment of acute intestinal obstruction,which could significantly reduce gastrointestinal decompression,shorten abdominal pain time and anal exhaust time,and has higher safety. It is speculated that the efficacy is closely related to the reduction of serum VIP and MDA levels by octreotide.It is worth further application in the clinic.
引文
[1] Arumugam PK,Dalal AK.Peritoneal encapsulation-an unexpected cause of acute intestinal obstruction[J]. J Visc Surg,2017,154(4):303-305.
[2] Shivakumar CR,Shoeb MFR,Reddy AP,et al.A clinical study of etiology and management of acute intestinal obstruction[J]. Int Surg J,2018,5(9):3072-3077.
[3]王金晶,汪志明,王震龙,等.经内镜放置小肠减压管在肠梗阻患者中的应用[J].中华消化内镜杂志,2016,33(9):643.
[4] Ambartsumyan L,Flores A,Nurko S,et al.Utility of octreotide in advancing enteral feeds in children with chronic intestinal pseudoobstruction[J].Pediatr Drugs,2016,18(5):387-392.
[5] Antonodimitrakis PC,Olofsson H,Grimelius L,et al.Neuroendocrine tumors with syndromic vasoactive intestinal polypeptide hypersecretion:a retrospective study[J]. International J Endocr Oncol,2017,4(1):9-22.
[6] PatlevicP,VakováJ,vorcJr P,et al.Reactive oxygen species and antioxidant defense in human gastrointestinal diseases[J]. Integr Med Res,2016,5(4):250-258.
[7]宫喜明.经鼻型肠梗阻导管治疗急性肠梗阻的临床效果观察[J].临床医药文献杂志,2018,5(98):45-46.
[8]陈勇,方庆,王向阳,等.奥曲肽治疗粘连性肠梗阻疗效及对患者血清血管活性肠肽水平影响观察[J].药物流行病学杂志,2016,25(12):11-13.
[9]俞谦.经鼻肠梗阻导管治疗难治性粘连性肠梗阻[J].中华消化内镜杂志,2016,33(8):561-562.
[10]陆耀,陈大伟,龚庆豪,等.不同手术时机对急性肠梗阻治疗效果与安全性的影响[J].现代仪器与医疗,2016,22(5):98-99.
[11] Sakaguchi S,Higa T,Suzuki M,et al.Prophylactic use of octreotide for asparaginase-induced acute pancreatitis[J]. Int J Hematol,2017,106(2):266-268.
[12]吴熙,杨渤彦,于雷,等.奥曲肽不同给药方式在恶性肠梗阻治疗中的应用研究[J].癌症进展,2017,15(5):505-508.
[13]杨新华,王瑞.奥曲肽结合鼻胃减压管治疗腹部手术致早期炎症性肠梗阻的临床效果[J].临床医学研究与实践,2017,2(10):64-65.
[14]顾春成,朱晶亮.奥曲肽治疗腹部手术后粘连性肠梗阻的疗效探讨[J].世界临床医学,2016,10(5):60-61.
[15]占小安,盛誉.急性肠梗阻治疗中应用经鼻小肠减压管置入术的临床观察[J].浙江创伤外科,2016,21(5):869-870.
[16] Wang Y,Wang W,Jin K,et al. Somatostatin receptor expression indicates improved prognosis in gastroenteropancreatic neuroendocrine neoplasm,and octreotide long acting release is effective and safe in Chinese patients with advanced gastroenteropancreatic neuroendocrine tumors[J]. Oncol Lett,2017,13(3):1165-1174.
[17] Wang N,Han Q,Wang G,et al.Resveratrol protects oxidative stress-induced intestinal epithelial barrier dysfunction by upregulating heme oxygenase-1 expression[J]. Digest Dis Sci,2016,61(9):2522-2534.
[2] Shivakumar CR,Shoeb MFR,Reddy AP,et al.A clinical study of etiology and management of acute intestinal obstruction[J]. Int Surg J,2018,5(9):3072-3077.
[3]王金晶,汪志明,王震龙,等.经内镜放置小肠减压管在肠梗阻患者中的应用[J].中华消化内镜杂志,2016,33(9):643.
[4] Ambartsumyan L,Flores A,Nurko S,et al.Utility of octreotide in advancing enteral feeds in children with chronic intestinal pseudoobstruction[J].Pediatr Drugs,2016,18(5):387-392.
[5] Antonodimitrakis PC,Olofsson H,Grimelius L,et al.Neuroendocrine tumors with syndromic vasoactive intestinal polypeptide hypersecretion:a retrospective study[J]. International J Endocr Oncol,2017,4(1):9-22.
[6] PatlevicP,VakováJ,vorcJr P,et al.Reactive oxygen species and antioxidant defense in human gastrointestinal diseases[J]. Integr Med Res,2016,5(4):250-258.
[7]宫喜明.经鼻型肠梗阻导管治疗急性肠梗阻的临床效果观察[J].临床医药文献杂志,2018,5(98):45-46.
[8]陈勇,方庆,王向阳,等.奥曲肽治疗粘连性肠梗阻疗效及对患者血清血管活性肠肽水平影响观察[J].药物流行病学杂志,2016,25(12):11-13.
[9]俞谦.经鼻肠梗阻导管治疗难治性粘连性肠梗阻[J].中华消化内镜杂志,2016,33(8):561-562.
[10]陆耀,陈大伟,龚庆豪,等.不同手术时机对急性肠梗阻治疗效果与安全性的影响[J].现代仪器与医疗,2016,22(5):98-99.
[11] Sakaguchi S,Higa T,Suzuki M,et al.Prophylactic use of octreotide for asparaginase-induced acute pancreatitis[J]. Int J Hematol,2017,106(2):266-268.
[12]吴熙,杨渤彦,于雷,等.奥曲肽不同给药方式在恶性肠梗阻治疗中的应用研究[J].癌症进展,2017,15(5):505-508.
[13]杨新华,王瑞.奥曲肽结合鼻胃减压管治疗腹部手术致早期炎症性肠梗阻的临床效果[J].临床医学研究与实践,2017,2(10):64-65.
[14]顾春成,朱晶亮.奥曲肽治疗腹部手术后粘连性肠梗阻的疗效探讨[J].世界临床医学,2016,10(5):60-61.
[15]占小安,盛誉.急性肠梗阻治疗中应用经鼻小肠减压管置入术的临床观察[J].浙江创伤外科,2016,21(5):869-870.
[16] Wang Y,Wang W,Jin K,et al. Somatostatin receptor expression indicates improved prognosis in gastroenteropancreatic neuroendocrine neoplasm,and octreotide long acting release is effective and safe in Chinese patients with advanced gastroenteropancreatic neuroendocrine tumors[J]. Oncol Lett,2017,13(3):1165-1174.
[17] Wang N,Han Q,Wang G,et al.Resveratrol protects oxidative stress-induced intestinal epithelial barrier dysfunction by upregulating heme oxygenase-1 expression[J]. Digest Dis Sci,2016,61(9):2522-2534.