摘要
目的:探讨生长抑素联合经鼻肠梗阻导管治疗腹部手术后早期炎性肠梗阻(EPISBO)的临床效果及对患者血清内毒素(LPS)、超敏C反应蛋白(hs-CRP)及肿瘤坏死因子(TNF)-α水平的影响。方法:选取2014年12月至2015年12月河北省唐山市人民医院收治的96例EPISBO患者,按随机数字表法分为观察组和对照组,每组48例。观察组采用生长抑素联合经鼻肠梗阻导管治疗,对照组采用常规鼻胃管治疗。比较两组患者的临床疗效,观察患者胃肠功能改善情况及不良反应发生情况,并采用酶联免疫吸附试验(ELISA)法测定患者血清LPS、hs-CRP和TNF-α水平。结果:观察组治疗总有效率为93.75%,明显高于对照组的72.92%(P<0.05)。观察组患者的排气、排便恢复时间、腹围缩小长度、胃肠减压程度及气液积累消失时间均明显优于对照组(均P<0.05)。治疗后两组患者血清LPS、hs-CRP及TNF-α水平明显下降,且观察组明显低于对照组(P<0.05)。对照组总不良反应发生率为37.50%,明显高于观察组的10.42%,差异有统计学意义(P<0.05)。结论:生长抑素联合经鼻肠梗阻导管治疗EPISBO的临床疗效显著,可明显降低血清LPS、hs-CRP及TNF-α水平,改善胃肠功能,且安全性较好。
Objective：To investigate the effects of somatostatin combined with via-nasal ileus tube on serum levels of endotoxin （LPS）, high-sensitivity C-reactive protein （hs-CRP） and tumor necrosis factor-α （TNF-α） in patients with early postoperative inflammatory small bowel obstruction （EPISBO）. Methods： 96 pa- tients with EPISBO underwent abdominal surgery in our hospital from December 2014 to December 2015 were selected and randomly divided into a control group and an observation group, with 48 cases in each group. Patients in the observation group received somatostatin combined with transnasal ileus tube thera- py, while those in the control group received routine nasogastric tube therapy. The clinical efficacy, gas- trointestinal function and the incidence of adverse reactions were observed. The levels of TNF-α, LPS and hs-CRP were measured by enzyme-linked immunosorhent assay （ELISA）. Results：The response rate in the observation group was 93.75%, which was markedly higher than that in the control group （72.92%~） （P〈0.05）. The recovery time of exhaust and defecation, the reduced length of abdominal circ- umference, gastrointestinal decompression, and the disappeared time of gas and liquid accumulation in the observation group were significantly higher than those in the control group （P〈0.05）. The levels of LPS, hs-CRP and TNF-α in the observation group were significantly lower than those in the control group （P〈0.05）. The incidence of adverse reactions were 37.50% and 10.42% respectively in the control group and the observation group, and the difference was statistically significant （P〈0.05）. Conclusion： The combina- tion of somatostatin and via-nasal ileus tube was effective in the treatment of EPISBO. It could improve the intestinal obstruction symptoms, reduce the levels of LPS, hs-CRP and TNF-α, and was safe.
作者
邵建富
李燕梅
李兴海
李文
王敬瑄
Shao Jianfu Li Yanmei Li Xinghai Li Wen Wang Jinxuan.(Department of General Surgery, The Peo- ples＇ Hospital of Tangshan, Tangshan 063001, China)
出处
《广西医科大学学报》
CAS
2017年第8期1160-1163,共4页
Journal of Guangxi Medical University
关键词
腹部手术后早期炎性肠梗阻
生长抑素
经鼻肠梗阻导管
炎症因子
early postoperative inflammatory bowel obstruction
somatostatin
via-nasal ileus tube
inflammatory factors
