Efficacy Of Octreotide In The Management Of Intestinal Obstruction: An Analysis Of 35 Cases

PURPOSE:To evaluate the efficacy of octreotide in the management of intestinal obstruction.METHODS: Diagnosis was made on symptoms (abdominal pain, bloating, vomiting, anal stop exhaust, defecation, etc.), signs (abdominal intestinal form, abdominal tenderness, rebound tenderness, bowel sounds hyperaction or disappear), and confirmed by iconography test (abdominal plain film or B- ultrasonography or CT or MRI). Selected cases were recorded of their sex, age, address, the time of the onset of symptoms caused to our hospital, and were recorded if they had operation before or chronic disease. After admission, fluid infusion volume was recorded too, to understand the general conditions of patients, we did routine blood, liver and kidney function tests, and continuous monitored objective indicators, including of white blood cells (WBC), red blood cells, platelets, serum albumin, alanine, aspartate transaminase, serum creatinine, urea nitrogen, abdominal plain film. During hospitalization, we improved the checks to clear the cause of obstruction. Used the nasogastric tube drainage when the patients had indications, recorded volume of drainage tube every 24 hours and observed the nature of drainage fluid。From 2009.09 to 2010.08, sixty-seven patients suffering from intestinal obstruction were randomly assigned into tow groups, octreotide group(N=35) and control group(N=32).There is no significant difference between the two groups about age, sex, the time of symptoms attack before in hospital and cause of disease(P >0.05).Patients in the control group were treated with routine therapy including gastroenteral decompression, vegetable oils inject through gastrictube, intravenous replacement of fluid and electrolytes,total parenteral nutrition and antibiotics. Patients in the control group received octreotide 0.1 mg H q8h for 3-14days plus routine therapy.After treatment, we observed and compared the clinical symptoms and signs, the volume of gastrointestinal decompression, drainage, electrolyte changes in indicators, complications and hospital stay between two groups.RESULTS: There are 76 cases in the trial, included adhesions of 23 cases (34%), tumor of 17 patients (25%). A total of 29 patients were cured, included 16 cases of adhesion, the overall cure rate is about 38%. After treatment, there is no significant difference between the two groups about cure rates(P >0.05).In octreotide group,remission rate of symptoms was 85.7% while the control group was 62.5%, P =0.029. The average of the amount of nasogastric drainage in the Octreotide group was 355.50±289.89ml/d ,while the control group was 595.63±287.22ml/d,P =0.014.Before treatment, there is 20case with gastrictube in the Octreotide group and 16cases in the control group. After 72h,16cases in octerotide group release the tube, while only 4cases in the control group(P <0.05). In octreotide group ,the average of abdominal pain relief time was 3.27±1.60 days, abdominal distention relief time was 3.00±1.55 days and exhaust time was 2.37±1.47 days, while those in the control group were 4.55±1.76 d,4.45±1.96 d ,and 3.20±1.58d,respectively(P