奥曲肽在活跃的非静脉曲张消化道溃疡出血中的临床疗效观察  

Effect of octreotide as an adjunct treatment in active nonvariceal upper gastrointestinal bleeding

作　　者：梁涛[1] 张建文[2] 

机构地区：[1]郑州大学第一附属医院药剂科,河南郑州450052 [2]郑州大学第一附属医院整形外科,河南郑州450052

出　　处：《中国医院药学杂志》2012年第18期1472-1475,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:观察奥曲肽在活跃的良性消化道溃疡出血中的治疗作用。方法:110例上消化道溃疡出血的患者,随机接受奥曲肽(55例)或安慰剂(55例)治疗。2组患者在年龄、性别、非甾体类抗炎药使用史、溃疡或出血病史、幽门螺旋杆菌感染、部位、出血的严重程度等方面没有差异性。镜下主要表现活跃喷血或渗血。在内镜下对所有患者局部喷撒去甲肾上腺素进行止血。结果:安慰剂组再次出血率是36%,奥曲肽组为16%。安慰剂组的18例患者(32.7%)和奥曲肽组的6例患者(11%)保守治疗无效,需要进行外科手术治疗。安慰剂组死亡为2例(3.6%),奥曲肽组死亡为3例(5.4%),上述结果差异有显著性。结论:奥曲肽作为消化道出血内镜下止血的辅助治疗方法,能降低再出血率,并减少了急诊手术以及消化道大出血死亡率。OBJECTIVE To determine the effect of octreotide on active or recent gastrointestinal bleeding from benign peptic ulcers.METHODS 110 patients with gastric or duodenal peptic ulcers presenting with active spurting or oozing bleeding or nonbleeding visible vessel were enrolled.All patients were subjected to endoscopic hemostasis by injection of noradrenaline,and they were then randomized to either receive octreotide（55 patients） or placebo（55 patients）.The groups did not differ with respect to age,sex,use of nonsteroidal antiinflammatory drugs,previous history of ulcer or bleeding,Helicobacter pylori infection,site,and severity of bleeding.RESULTS The rebleeding rate was 36% in placebo and 16% in octreotide group,which does not present a statistically significant difference.Surgical intervention was required for 18 patients（32.7%） in the placebo group and for 6 patients（11%） in the octreotide group.The mortality rate was 2 patients（3.6%） in the placebo and 5patients（5.4%） in the octreotide group.All the above presented statistical difference.In addition,there was no statistically significant difference between the 2 groups with respect to hospitalized time.CONCLUSION The use of octreotide as an adjunct treatment in patients with acutely bleeding benign peptic ulcer or/and visible vessel did seem to offer significant benefits regarding their outcome.

关 键 词：奥曲肽 非静脉曲张性急性胃肠道出血 疗效观察 

分 类 号：R969[医药卫生—药理学]