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生长抑素联合红霉素对腹部损伤术后应激炎性因子的影响

Effect of somatostatin combined with erythromycin on stress inflammatory factors after surgery for abdominal injury

  • 摘要: 目的:观察生长抑素联合红霉素对腹部损伤术后机体应激炎性因子的影响。方法:选择河北北方学院附属第一医院普通外科因腹部损伤行手术治疗的90例患者,根据治疗方式分为对照组30例、单药组30例和联合组30例。对照组术后常规给予吸氧、胃肠减压、营养支持和纠正水电解质平衡等治疗;单药组在对照组基础上给予红霉素治疗;联合组在对照组基础上辅以生长抑素和红霉素治疗。记录3组患者肠鸣音恢复时间、首次排气时间、首次排便时间、平均住院时间;检测术前,术后第1、3、5天血清皮质醇(Cor)、C反应蛋白(CRP)、白细胞介素6(IL-6)、IL-10水平。结果:联合组术后肠鸣音恢复时间、首次排气时间、首次排便时间、平均住院时间均明显早于单药组和对照组(P<0.05),单药组上述指标早于对照组(P<0.05)。3组术前血清Cor、CRP、IL-6、IL-10水平差异无统计学意义。术后各指标先逐步上升后逐步下降,术后Cor、CRP、IL-6在第1天、第3天、第5天水平均为联合组<单药组<对照组(P<0.05),IL-10反之;其中联合组术后第5天血清Cor、IL-6水平趋于术前水平,对照组和单药组仍明显高于术前水平(P<0.05)。结论:生长抑素联合红霉素可进一步降低腹部损伤术后血清Cor、CRP、IL-6、IL-10水平,有助于术后快速康复。

     

    Abstract: Objective:To observe the effect of somatostatin combined with erythromycin on stress inflammatory factors after surgery for abdominal injury. Methods:Ninety patients undergoing surgery for abdominal injury at the Department of General Surgery, the First Affiliated Hospital of Hebei North University were selected and divided into the control group (30 cases), the single drug group (30 cases), and the combination group (30 cases) according to the treatment methods. The patients in the control group were treated routinely with oxygen inhalation, gastrointestinal decompression, nutrition support, and water electrolyte balance correction; the patients in the single drug group were treated with erythromycin on the basis of the control group; and the patients in the combination group were treated with somatostatin combined with erythromycin on the basis of the control group. The recovery time of bowel sounds, the first-exhaust time, the first-defecation time, and the average time of hospital stay were recorded. The serum cortisol (Cor), C-reactive protein (CRP), interleukin (IL)-6, and IL-10 levels before surgery and first, third, and fifth day after surgery were detected. Results:The recovery time of bowel sounds, the first-exhaust time, the first-defecation time, the average time of hospital stay in the combination group were significantly earlier than those in the control group and the single drug group, and the above parameters in the single drug group were significantly earlier than those in the control group (P<0.05). There was no difference among the three groups in serum Cor, CRP, IL-6, and IL-10 levels before the surgery. The above parameters gradually increased and then gradually decreased after the surgery. The Cor, CRP, and IL-6 levels on the first, third, fifth day after the surgery showed a trend that is: combination group < single drug group < control group (P<0.05), whereas an opposite trend was found for the IL-10 level; for the combination group, the serum levels of Cor and IL-6 on the fifth day after the surgery were close to those before the surgery (P<0.05), but for the single drug group and the control group, they were still higher than those before the surgery (P<0.05). Conclusions:Somatostatin combined with erythromycin has better effects on the serum levels of Cor, CRP, IL-6, and IL-10, which is beneficial to the quick recovery after the surgery.

     

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