生长抑素在结直肠术后肠瘘中的应用研究

目的观察生长抑素在结直肠癌患者术后肠瘘中的应用效果。方法选取32例术后发生肠瘘的结直肠癌患者并随机分为两组,16例患者采用禁食,补液,抗炎,胃肠减压或外引流等基础治疗作为对照组,16例患者在对照组基础上加用生长抑素6mg.d-1微量泵输入治疗作为观察组,观察比较两组患者肠瘘恢复情况及并发症发生情况,同时对漏出液时行检测,观察比较两组患者漏出液血清淀粉酶及胆汁酸水平。结果观察组恢复正常饮食时间,住院时间及瘘口闭合时间均较对照组明显缩短,观察组血清淀粉酶、胆汁酸及红细胞比容水平明显低于对照组,差异具有统计学意义(P0.05),观察组5例发生并发症,对照组3例发生并发症,两组并发症发生率无显著差异(P0.05)。结论对结直肠癌患者术后肠瘘患者采用基础治疗的同时,辅以生长抑素治疗,可进一步减少消化液分泌,促进瘘口修复,缩短住院时间,疗效显著。

Somatostatin in the colorectal bowel fistula

Objective To observe the application somatostatin to rectal cancer patients with postoperative intestinal fistula. Methods 32 cases of intestinal fistula after eolorectal cancer patients were randomly assigned into two groups, 16 patients with fast, fluid, anti-inflam- matory,gastrointestinal decompression or external drainage and other basic treatment as the control group, 16 cases patients with soma- tostatin 6 mg ~ d - ~ micro pump input treatment on the basis of the control group as the observation group. The two groups were compared in recovery after intestinal fistula and occurrence of complications. The two groups were also compared in leak fluid serum amylase and bile acid levels. Results The time of reverting to normal diet, hospital stay and fistula closure time, compared with the control group, were significantly shorter. Serum amylase, bile acid and hematoerit levels were significantly lower in the observation group than in the con- trol group, wiht a statistically significant difference（ P 〈 0.05 ）. Of the observation group five cases had complications, while in the control group three cases of complications occurred. There was no significant difference in the incidence of complications（ P 〉 0.05 ）. Conclusion The basic treatment of colorectal cancer patients after surgery in patients with intestinal fistula, combined with somatostatin treatment, may further reduce the secretion of digestive juice, promote fistula repair, shorten hospital stay.