Martineau P, Shwed J A, Denis R
Faculté de Pharmacie, University of Montreal, Quebec, Canada.
Am J Surg. 1996 Oct;172(4):386-95. doi: 10.1016/S0002-9610(96)00193-6.
Octreotide is a long-acting analogue of somatostatin that exhibits good subcutaneous absorption. It reduces gastrointestinal and pancreatic secretions as well as relaxes the intestinal musculature. It has been hypothesized that octreotide could decrease fistula output, thus facilitating fluid and electrolytes management and possibly hasten fistula closure.
Relevant articles were identified from a MEDLINE search of the literature. Because of the scarcity of well-designed studies on the use of octreotide to promote enterocutaneous and pancreaticocutaneous fistulas closure, all case series and controlled trials were reviewed.
Octreotide as an adjuvant to standard fistula management diminishes fistula output, but its shortening of the time to fistula closure remains to be proven by well-designed comparative trials. For recent onset fistulas (less than 8 days old), octreotide does not seem better than the recommended management, including parenteral nutrition. Octreotide can effectively prevent postoperative complications and fistula formation in patients undergoing elective pancreatic resection.
奥曲肽是一种长效生长抑素类似物，皮下吸收良好。它可减少胃肠道和胰腺分泌，并松弛肠道肌肉组织。据推测，奥曲肽可减少瘘管排出量，从而便于液体和电解质管理，并可能加速瘘管闭合。
通过对MEDLINE文献检索确定相关文章。由于关于使用奥曲肽促进肠皮肤瘘和胰皮肤瘘闭合的设计良好的研究较少，因此对所有病例系列和对照试验进行了综述。
奥曲肽作为标准瘘管管理的辅助手段可减少瘘管排出量，但其缩短瘘管闭合时间仍有待设计良好的对照试验证实。对于近期发生的瘘管（小于8天），奥曲肽似乎并不优于推荐的管理方法，包括肠外营养。奥曲肽可有效预防择期胰腺切除患者的术后并发症和瘘管形成。
