Sleth J C, Andraos Y, Borie F, Dumay R, Legroux P
Département d'Anesthésie-Réanimation, CHG Béziers.
Ann Fr Anesth Reanim. 1994;13(5):738-40. doi: 10.1016/s0750-7658(05)80733-6.
Two patients with enterocutaneous fistulas (ileal and duodenal) were successfully treated with bowel rest, total parenteral nutrition and the somatostatin analogue octreotide (150 micrograms.day-1 and 300 micrograms.day-1 respectively). At the time octreotide was started the first patient had a high output fistula (1 000 mL.day-1), the second had a low output fistula (120 mL.day-1). Within 24 hours of treatment, a reduction of at least 40% of the output was observed. The time intervals to fistula closure were respectively 6 days and 10 days after initiation of octreotide therapy. Glucose intolerance was not observed. The efficacy of octreotide combined with total parenteral nutrition supports its routine use instead of somatostatin, more expensive, less tolerated and presenting the risk of rebound effect.
两名患有肠皮肤瘘（回肠和十二指肠）的患者通过肠道休息、全胃肠外营养以及生长抑素类似物奥曲肽（分别为150微克/天和300微克/天）成功治愈。开始使用奥曲肽时，第一名患者为高流量瘘（1000毫升/天），第二名患者为低流量瘘（120毫升/天）。治疗24小时内，观察到瘘液排出量至少减少40%。奥曲肽治疗开始后，瘘管闭合的时间间隔分别为6天和10天。未观察到葡萄糖不耐受情况。奥曲肽联合全胃肠外营养的疗效支持其常规使用，而非使用生长抑素，因为生长抑素价格更高、耐受性较差且有反跳效应风险。
