Analysis Of Curative Effect Of Somatostatin Analogue Combined With Acid Inhibitors On Malignant Intestinal Obstruction

Objective:On the basis of the conventional treatment,we investigated the therapeutic effect that somatostatin analogue(SSA)was combined with acid inhibitors(proton pump inhibitors or H2 receptor antagonist)to treat the intestinal obstruction which was caused by advanced malignant tumors(MT),and compared the effect of two kinds of acid inhibitors in order to provide more reasonable and effective treatment for the patients.Methods:A retrospective analysis of 104 cases in The First Affiliated Hospital of Henan University from January 2017 to September 2019 with intestinal obstruction which was caused by advanced MT has been done.They were divided into control group,observation group1 and observation group2 according to different treatment methods.The control group(35 cases)received conventional treatments such as fasting and water deprivation,gastrointestinal decompression,anti-infection and fluid replacement.The observation group1(37 cases)used SSA(octreotide,0.3-0.6 mg / d micropump continuous intravenous drip)and PPI(Omeprazole sodium for injection,40 mg / d intravenous drip)on the basis of the conventional treatment.The observation group2(32 cases)used SSA treatment(usage and dosage were the same as observation group1)and H2RA(Famotidine injection,40 mg / d,intravenous drip)on the basis of the conventional treatment.We have observed the relief time of clinical symptom,the time of using nasogastric tube,the average Length of Stay,the karnofsky scores(KPS),the gastrointestinal decompression capacity,the changes of C-reactive protein(CRP)levels,the improvement of imaging examination and the relief rate of symptom to compare and analyze the therapeutic effects of the three groups.Results:1.The effect of SSA combined with acid inhibitor:(1)both of the observation groups used less time in relieving clinical symptom and removing nasogastric tube than the control group and the difference was statistically significant(P<0.05).(2)Before treatment,the KPS scores were very similar between the two observation groups and the control group.The difference was not statistically significant(P>0.05).After treatment,the KPS scores of the three groups were significantly higher than that before treatment,The difference was statistically significant(P<0.05).The KPS scores of the two observation groups were higher than the control group.The difference was statistically significant(P < 0.05).(3)The amount of gastrointestinal decompression in three groups was similar on the first day.The difference was not statistically significant(P>0.05).On the 3rd,5th and 7th days,the gastrointestinal decompression volume of the two observation groups was less than the control group.The difference was statistically significant(P<0.05).(4)In the laboratory examination,the CRP levels between the two observation groups and the control group were similar on the first day,and the difference was not statistically significant(P>0.05).On the 3rd,5th and 7th days,the CRP levels in the two observation groups were significantly lower than those in the control group,and the difference was statistically significant(P<0.05).(5)The improvement rate of imaging examination and the remission rate of clinical symptoms in the two observation groups were significantly higher than those of the control group on the 7th and 14 th days,and the difference was statistically significant(P<0.05).(6)The average Length of Stay in the two observation groups was shorter than that in the control group,and the difference was statistically significant(P<0.05).2.The effect of different acid inhibitors:(1)For relieving clinical symptom and the time of using nasogastric tube:(1).The time to alleviate bellyache and start defecating and venting in the two observation groups was similar and there was no significant difference(P>0.05).(2).For controlling nausea,vomiting and the use of nasogastric tube,the time of observation group2 was shorter than that of the observation group1,and the difference was statistically significant(P<0.05).(2)Before and after treatment,the KPS scores of the two observation groups were similar,and the difference was not statistically significant(P> 0.05).(3)In the dynamic observation,the gastrointestinal decompression volume of the two observation groups was similar on the first day and the third day,and there was no significant difference(P>0.05);However,on the fifth day and seventh day,the amount in observation group2 was less than that in observation group1,and the difference was statistically significant(P<0.05).(4)About laboratory examination,the CRP levels of the two observation groups on the 1st,3rd,5th,and 7th days were similar,and the difference was not statistically significant(P>0.05).(5)On the 7th day and 14 th day,the improvement rate of radiological examination and symptom alleviation rate in the two observation groups were similar,and there was no significant difference(P>0.05).(6)The average Length of Stay was similar between the two observation groups.The difference was not statistically significant(P>0.05).Conclusion:The use of SSA and acid inhibitors(PPI / H2RA)on the basis of conventional treatment could quickly relieve the symptoms of abdominal distension,abdominal pain,nausea and vomiting in patients with MBO,accelerate the recovery of gastrointestinal function,reduce the time of using nasogastric tubes,shorten the average Length of Stay and improve the quality of life for the patients.And when H2 RA is chosen as the antacid inhibitor,it is more effective in reducing the secretion of digestive juice,relieving the symptoms of nausea and vomiting,and shortening the time of using nasogastric tube.