Lamers C B, Bijlstra A M, Harris A G
Department of Gastroenterology, University Hospital Leiden, The Netherlands.
Dig Dis Sci. 1993 Feb;38(2):359-64. doi: 10.1007/BF01307556.
Severe long-term complaints of dumping occur in a small number of patients after gastric surgery. Dietary modification, fiber preparations, and medical therapy are often ineffective. In these severely affected patients administration of the somatostatin analog octreotide before meals appears to be a promising new strategy. The effects of octreotide on both gastrointestinal transit time and hormonal changes appear to contribute to the benefits seen in dumping syndrome. However, as the majority of studies conducted have employed only a single dose of octreotide, careful long-term assessment of the nutritional and metabolic effects will be required. Recent results suggest that octreotide may be administered up to 2 hr before a meal and therefore has a sufficiently long duration of action to be of practical long-term use. Moreover, general improvements in life-style, as well as beneficial effects on symptoms, have been reported with long-term treatment, although the potential development of diarrhea will require careful monitoring. The development of an oral or nasal formulation should further improve the practical application of octreotide as a treatment for dumping syndrome.
少数患者在胃手术后会出现严重的长期倾倒综合征症状。饮食调整、纤维制剂和药物治疗往往无效。对于这些受影响严重的患者，饭前服用生长抑素类似物奥曲肽似乎是一种有前景的新策略。奥曲肽对胃肠道转运时间和激素变化的影响似乎有助于改善倾倒综合征。然而，由于大多数研究仅使用了单剂量的奥曲肽，因此需要对营养和代谢效应进行仔细的长期评估。最近的结果表明，奥曲肽可在饭前2小时给药，因此其作用持续时间足够长，可实际长期使用。此外，长期治疗报告显示生活方式普遍改善，症状也有有益影响，尽管腹泻的潜在发展需要密切监测。口服或鼻用制剂的开发应进一步改善奥曲肽作为倾倒综合征治疗药物的实际应用。
