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兰瑞肽长效凝胶用于全结肠切除术后持续性腹泻的治疗

Lanreotide Autogel in the Treatment of Persistent Diarrhea following a Total Colectomy.

作者信息

Schoeters Patrick, De Pooter Karl

机构信息

Department of Gastroenterology, AZ Herentals, 2200 Herentals, Belgium.

Department of Gastrointestinal Surgery, AZ Herentals, 2200 Herentals, Belgium.

出版信息

Case Rep Gastrointest Med. 2015;2015:686120. doi: 10.1155/2015/686120. Epub 2015 Dec 6.

Abstract

Diarrhea is one of the most common complications following colectomy in patients with slow transit constipation (STC). Early postoperative diarrhea is usually treated with opioid agonists; however, to date, published data on the management of persistent diarrhea after colectomy for STC are scarce. Here, we report a case of severe diarrhea after a total colectomy with ileorectal anastomosis. One year after the surgery, the patient presented with persistent diarrhea. Treatment with a long-acting somatostatin analogue, lanreotide Autogel, was initiated. One month after the first injection of lanreotide Autogel the diarrhea was resolved. The patient's stool transit was markedly improved (type 4 or type 5 according to the Bristol Stool Chart compared to type 7 before the treatment), positively affecting the patient's quality of life (mean score of 2.1 on the Irritable Bowel Syndrome Quality of Life questionnaire compared to 3.9 before the treatment). This case report describes a successful use of lanreotide Autogel in a patient with persistent diarrhea after a total colectomy.

摘要

腹泻是慢传输型便秘(STC)患者结肠切除术后最常见的并发症之一。术后早期腹泻通常用阿片类激动剂治疗;然而,迄今为止,关于STC结肠切除术后持续性腹泻管理的已发表数据很少。在此,我们报告一例全结肠切除回直肠吻合术后严重腹泻的病例。手术后一年,患者出现持续性腹泻。开始使用长效生长抑素类似物兰瑞肽Autogel进行治疗。首次注射兰瑞肽Autogel一个月后,腹泻得到缓解。患者的粪便转运明显改善(根据布里斯托大便分类法为4型或5型,而治疗前为7型),对患者的生活质量产生了积极影响(肠易激综合征生活质量问卷平均评分为2.1分,而治疗前为3.9分)。本病例报告描述了兰瑞肽Autogel在全结肠切除术后持续性腹泻患者中的成功应用。

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Understanding and treating refractory constipation.理解与治疗难治性便秘。
World J Gastrointest Pharmacol Ther. 2014 May 6;5(2):77-85. doi: 10.4292/wjgpt.v5.i2.77.
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Surgical management of colonic inertia.结肠无力的外科治疗
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The pathophysiology of chronic constipation.慢性便秘的病理生理学
Can J Gastroenterol. 2011 Oct;25 Suppl B(Suppl B):16B-21B.
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Epidemiology and burden of chronic constipation.慢性便秘的流行病学与负担
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