Mackie C R, Jenkins S A, Hartley M N
Department of Surgery, University of Liverpool, UK.
Br J Surg. 1991 Nov;78(11):1338-43. doi: 10.1002/bjs.1800781123.
Fourteen patients with severe and persistent postvagotomy/postgastrectomy symptoms were entered into a trial of treatment with the somatostatin analogue octreotide, 50 micrograms twice daily 30 min before meals being self-administered by subcutaneous injection. Six of the seven patients completing the 3-month trial showed sustained overall improvement of symptoms. The remaining patients were unhelped by treatment or developed unwanted effects. Six of eight patients with dumping syndrome showed sustained improvement of dumping symptoms during treatment. Bile vomiting was relieved in three of four patients with this complaint. Diarrhoea accompanying dumping showed a variable response to treatment, with improvement in three patients and no change or worsening of this symptom in five. Two patients with severe postvagotomy diarrhoea alone showed no improvement. Four patients with unwanted effects and three patients who found no benefit stopped the trial medication early. Four further patients reported mild or transient side-effects. For patients with severe postvagotomy/postgastrectomy symptoms, a trial of octreotide seems justified when significant dumping symptoms are present and other treatment options have been exhausted.
14例迷走神经切断术/胃切除术后出现严重且持续症状的患者进入了一项使用生长抑素类似物奥曲肽的治疗试验，患者在饭前30分钟自行皮下注射，剂量为每日两次，每次50微克。完成3个月试验的7例患者中，有6例症状持续全面改善。其余患者治疗无效或出现了不良反应。8例倾倒综合征患者中有6例在治疗期间倾倒症状持续改善。4例胆汁反流性呕吐患者中有3例症状得到缓解。伴随倾倒综合征的腹泻对治疗反应不一，3例患者症状改善，5例患者症状无变化或加重。仅2例严重迷走神经切断术后腹泻患者症状未改善。4例出现不良反应的患者和3例未获益处的患者提前停止了试验用药。另有4例患者报告了轻微或短暂的副作用。对于迷走神经切断术/胃切除术后出现严重症状的患者，当存在明显的倾倒症状且其他治疗方法均已用尽时，奥曲肽试验似乎是合理的。
