奥曲肽治疗晚期卵巢癌所致肠梗阻的疗效观察

目的 研究奥曲肽治疗晚期卵巢所致肠梗阻的作用. 方法 将通过临床症状和腹部X线平片及PET/CT明确诊断为晚期卵巢癌所致肠梗阻非手术治疗患者64例分为两组:对照组(n=34)常规治疗,即禁食、鼻胃管胃肠减压、灌肠、全肠外营养(total parenteral nutrition,TPN)支持；治疗组(n=30)除常规治疗外,使用奥曲肽治疗,剂量为0.6 mg/d,持续静脉泵入.观察两组治疗开始前1d、治疗第4和第7d的鼻胃管引流量.当症状缓解、排气、鼻胃管引流量≤100 ml/d时,拔除鼻胃管,同时观察两组的鼻胃管拔除率. 结果 两组患者经治疗后病情均出现明显缓解.两组患者经治疗后病情均出现明显缓解.与对照组相比,治疗组治疗第4d胃液引流量显著减少,为(573.6 ±312.1)ml/dvs.(1 003.9±275.2) ml/d(P＜0.001),治疗第7d进一步减少,为(78.4±116.2) ml/d vs.(487.3±103.5) ml/d (P＜0.001).治疗组患者鼻胃管拔除率显著提高(83.3％vs.20.6％,P＜0.001).结论 奥曲肽可显著减少胃液的引流量,使大部分患者摆脱胃肠减压和TPN,在晚期癌性肠梗阻患者非手术治疗中具有重要作用.

Clinical Observation of Octreotide in the Management of Intestinal Obstruction in Advanced Ovarian Cancer

Objective To evaluate the role of octreotide in the management of intestinal obstruction in advanced ovarian cancer.Methods: Sixty-four patients with inoperable intestinal obstruction in advanced ovarian cancer received octreotide 0.6mg daily(n=30) or routine therapy,such as fasting,decompression with nasogastric tube,lavation and total parenteral nutrition(n=34).Diagnosis was made on the clinical grounds and confirmed by plain abdominal radiography and PET/CT.The volume of drainage fluid from the nasogastric tube and the rate of the nasogastric tube removals were assessed at the baseline,fourth and seventh day of the treatment,respectively.Results Data analysis showed statistically significant differences between the two groups.At the forth day after palliative therapy,the drainaged gastrointestinal fluid of the octreotide group was significantly reduced comparing with the routine group,(573.6±312.1)ml/d vs.(1 003.9±275.2)ml/d(P<0.001),and the rate of gastric tube removals was 16.7% vs.0(P<0.05).A week of octreotide treatment further reduced the drainaged gastrointestinal fluid,(78.4±116.2)ml/d vs.(487.3±103.5)ml/d(P<0.001),and raised the rate of gastric tube removals(83.3% vs.20.6%,P<0.01).Conclusion Octreotide is an effective drug for the palliative treatment in ovarian cancer induced intestinal obstruction.