摘要
目的观察超早期糖皮质激素治疗对术后早期炎性肠梗阻的临床疗效及安全性.方法收集遵义医学院附属医院2013年12月至2017年12月收治的40例胃肠吻合术后10d内发生早期炎性肠梗阻患者的临床资料并进行回顾性分析.根据治疗方式分为观察组(19例)对照组(21例).观察组应用小剂量糖皮质激素联合生长抑素治疗;对照组应用生长抑素进行治疗.比较两组治疗后3、7、10d炎性肠梗阻临床缓解率,观察两组吻合口瘘发生情况.结果观察组和对照组治疗3d后炎性肠梗阻缓解率分别为52.6%(10/19)和19.0%(4/21)(χ^2=4.945,P<0.05);治疗7d后缓解率分别为78.9%(15/19)和47.6%(10/21)(χ^2=4.177,P<0.05);治疗10d后缓解率分别是94.7%(18/19)和66.7%(14/21)(χ^2=4.912,P<0.05).两组经过保守治疗均获得临床缓解,观察组最长治疗时间为12d,对照组最长治疗时间为16d.两组均无吻合口瘘发生.结论早期小剂量糖皮质激素联合生长抑素治疗炎性肠梗阻可以快速缓解肠梗阻,缩短疗程,促进早期恢复,未增加吻合口瘘发生率,疗效确切、安全.
Objective To observe the clinical efficacy and safety of glucocorticoid therapy in the treatment of early postoperative inflammatory intestinal obstruction. Methods The clinical data of 40 patients with early postoperative inflammatory intestinal obstruction after gastrointestinal anastomosis admitted from December 2013 to December 2017 in the Affiliated Hospital of Zunyi Medical College were retrospectively analyzed. According to treatment methods, the patients were divided into observation group ( 19 cases ) and control group ( 21 cases ). The observation group was treated with low-dose glucocorticoid combined with somatostatin;the control group was treated with somatostatin. The clinical remission rates of the patients were compared 3 days, 7 days, and 10 days after treatment between the two groups. The occurrence of anastomotic leakage was observed. Results After treatment, the effective rate of the observation group and the control group after 3 days of treatment was 52. 6%( 10/19 ) and 19. 0%(4/21),χ^2 =4. 945,P<0. 05. After 7 days of treatment, the effective rates were 78. 9%(15/19) and 47. 6%(10/21),χ^2 =4. 177,P<0. 05;after 10 days of treatment, the effective rate was 94. 7%(18/19) in observation group and 66. 7%(14/21) in control group (χ^2 =4. 912, P<0. 05). Both groups received clinical improvement after conservative treatment. No anastomotic leakage occurred in the two groups. Conclusions Early low-dose glucocorticoid combined with somatostatin in the treatment of early postoperative inflammatory intestinal obstruction can promote early recovery, and has safe efficacy, without increase in incidence of anastomotic leakage.
作者
李源
程家平
Li Yuan;Cheng Jiaping(Department of Gastrointestinal Surgery,Affiliated Hospital of Zunyi Medical College,Zunyi 563099,China)
出处
《中国实用医刊》
2019年第16期114-117,共4页
Chinese Journal of Practical Medicine
关键词
早期炎性肠梗阻
糖皮质激素
地塞米松
生长抑素
Early postoperative inflammatory intestinal obstruction
Glucocorticoids
Dexamethasone
Somatostatin
