重症颅脑损伤患者中生长抑素应用探究.docVIP

重症颅脑损伤患者中生长抑素应用探究【摘要】 目的探讨生长抑素应用于重症颅脑外伤患者的临床价值。方法 41 例重症颅脑损伤患者分为两组:A组(n=23)入住ICU后即予注射用生长抑素(思他宁)持续静脉泵入, 250 μg/h,维持72 h。B组(n=18)不用思他宁,其他治疗措施同A组。记录消化道出血等胃肠道症状出现频率、营养指标、每天胰岛素的用量、患者预后等数据。结果 A组胃肠道症状出现频率明显少于B组,一周后的营养指标优于B组,每天胰岛素的用量明显少于B组,两组患者一周后 APACHEⅢ 评分和两周内死亡率差异无统计学意义。结论 生长抑素应用于重症颅脑外伤患者可以减少消化道出血的发生,更有助于肠内营养实施,改善营养指标,稳定血糖水平,但尚无可以改善患者预后的证据。 【关键词】 生长抑素;思他宁;重症颅脑损伤 The research ofapplicationofsomatostatininto severe craniocerebralinjuriedpatients WANG guang-bin, BU Uui-ju, LIN Xiao-mao, et al. Deparment of Cerebral Surgery, Donghua Hospital Affiliated to Sun Yat-sen University,Dongguan 523110,China 【Abstract】 Objective To discuss the clinical value of Somatostatin (Stilamin) in severe craniocerebralinjuriedpatients. Methods 41 severe craniocerebralinjuriedpatients were divided into two groups:group A(n=23)patients were sent to intense care unit and were continuously injected Somatostatin (Stilamin) for 72 hours, 250 ugperhour. Group B(n=18)with the same treatments as groupAexcept for Somatostatin.The amount of gastroentero symptoms such as alimentary canal hemorrhage, theindexes of nutrition, the dosageofinsulineveryday, the prognosis of paitents were recorded. Results The amount of gastroentero symptoms and needing dosage of insulin in group Awas smaller than that of group B,and the indexes of nutrition after a week were better than group B, APACHE Ⅲ grade after a week and death rate in two weeks were similar in the two groups. Conclusion Using Somatostatin (Stilamin) in severe craniocerebralinjuriedpatients can reduce the rate of alimentary canal hemorrhage,benefit to udergo entero-nutrition, improve indexes of nutrition,stabilize the level ofbloodsugar, but no evidences are found to prove that it can reform the prognosis of these paitents. 【Key words】 Somatostatin ; Stilamin;Severe craniocerebral injury 作者单位:523011中山大学附属东华医院脑外科 重症颅脑外伤致残率、病死率相当高,严重威胁人民生命健康,要提高其治疗水平,不是单一措施可以做到的,必须采用综合治疗的手段。应激性溃疡、血糖紊乱、返流误吸是加重病情的几个重要因素。生长抑素是一种脑肠肽,广泛存在于中枢神经和胃肠道消化系统。它可以抑制胰