1.Application of somatostatin in nonoperative treatment of different kinds of intestinal obstruction
Yanzhang ZHUANG ; Liangxi HUANG ; Peng HUANG
Chinese Journal of Primary Medicine and Pharmacy 2015;22(1):38-41
Objective To investigate the therapeutical effects of somatostatin in nonoperative treatment of different kinds of intestinal obstruction.Methods 338 cases of intestinal obstruction accepted by our hospital were retrospectively analyzed,which were divided into adhesive intestinal obstruction,inflammatory intestinal obstruction and malignant tumor intestinal obstruction.With nonoperative treatment,the control group were treated with routine therapy,including fasting,gastrointestinal decompression,intestinal lavage,intravenous replacement of fluid and electrolytes,disturbance of acid-base balance and the application of antibiotics.As for the treatment group,they were pumped with 6mg of somatostatin and 120mL physiological saline as well as routine therapy for 24 hours.The effects of the two groups were compared.Results The remission rate of abdominal distension and abdominal pains was 80.2% in the treatment group and 62.3% in the control group,the difference was statistical significance (x2 =250.446,P < 0.05).The remission rate of nausea and vomiting was 84.1% in the treatment group and 87.7% in the control group.The passage of gas and defecation by anus was 64.7 % in the treatment group and 61.6% in the control group,there was no clear difference between the two groups (x2 =0.902,0.349,all P > 0.05).The gastrointestinal decompression amounts reduced clearly,the treatment group was (328 ±229) mL/d and (694 ± 381) mL/d in the control group,there was significant difference (t =2.883,P < 0.05).After nonoperative conservative treatment,the effects between the two groups were as follows:the effective percentage was 95.7% in the treatment group and 94.0% in the control group,there was no significant difference(x2 =0.007,P > 0.05).Except intestinal obstruction patients with external tumors,the rates of transferring to operation was 2.4 % in the treatment group and 2.8 % in the control group,there was no statistical significance(x2 =0.051,P > 0.05).And except patients of intestinal obstruction with external tumors and transferring to operation,the hospital stay was (10.6 ±4.9) d in the treatment group and (15.3 ± 4.1) d in the control group,the difference was significant (t =2.528,P < 0.05).As for the treatment group with somatostatin,there was no significant difference(x2 =0.008,0.230,t =0.117,all P > 0.05) in abdominal distension and abdominal pains of adhesive and inflammatory intestinal obstruction,promoting the passage of gas and defecation by anus,the improvement of gastrointestinal decompression amounts in 24 hours.The improvement of tumor intestinal obstruction was worse.Conclusion Somatostatin treatment can help to ease the symptoms and physical signs of different kinds of intestinal obstruction rapidly and cut down hospital stay clearly,but can not reduce the rates of transferring to operation.If the time of treatment is ignored,it can not improve the therapeutical effective percentage of intestinal obstruction obviously.There is no significant difference for the application of adhesive and inflammatory intestinal obstruction.However,it can not completely and well improve the symptoms of tumor intestinal obstruction and the symptoms can recrudesce easily.