奥曲肽治疗肝硬化食管胃底静脉曲张破裂出血40例  

Esophageal Cardiac Varicosis Bleeding due to Hepatic Cirrhosis Treated with Sandostatin

作　　者：王玉俊[1] 孙晓军 

机构地区：[1]拜泉县人民医院,黑龙江拜泉161700 [2]肇东市人民医院,黑龙江肇东151100

出　　处：《黑龙江医学》2004年第5期368-369,共2页Heilongjiang Medical Journal

摘　　要：目的　探讨奥曲肽对食管胃底静脉曲张破裂出血的疗效。方法　经胃镜检查确诊的 4 0例肝硬化失代偿期病人 ,食管胃底静脉破裂出血 ,肝功能ChildA级 3例、B级 2 7例、C级 1 0例。呕血量 >1 0 0mL。应用奥曲肽首次 1 0 0 μg静注 ,继之以 2 5 μg/h的速度持续静脉滴注 2 4～ 4 8h。 结果　 1 5例用药后 1d止血 ,9例 2d止血 ,8例 3d止血 ,6例 5d止血 ,加用三腔管压迫后 6d止血 ,1例无效死亡。结论　奥曲肽可选择性收缩内脏血管 ,通过抑制血管活性肽和促胃液素释放 ,减少门脉血流量 。Objective To discuss esophageal cardiac varicosis bleeding due to hepatic cirrhosis treated with sandostatin. Methods 40 cases of such patient obtained the diagnosis were classified 3 cases in Child A, 27 cases in Child B and 10 cases in Child C based on liver function. The sandostatin was injected 100 mg intravenously first and maintained 25 μg/h for 24～48 h. Results There were 15 cases bleeding stopped after 1 d treatment, 9 cases after 2 d, 8 cases after 3 d, 6 cases after 5 d and 6 cases bleeding stopped at 5 d after used trilumen tube compression. 1 case was died. Conclusion Sandostatin could constrict visceral blood vessels and decrease the portal vein flow through inhibit vascular bioactive peptide and gastrin releasing to stop bleeding.

关 键 词：外科学 奥曲肽 肝硬化 食管胃底静脉曲张 出血 

分 类 号：R657.31[医药卫生—外科学]