不同剂量醋酸奥曲肽治疗肝硬化食管胃静脉曲张破裂出血的临床观察  

Clinical Observation of Different Doses of Acetic Octreotide in the Treatment of Esophagogastric Varicose Hemorrhage in Patients with Liver Cirrhosis

作　　者：黄欣[1] 杨柳[1] 

机构地区：[1]上海交通大学医学院附属第九人民医院消化科,上海200011

出　　处：《中国药房》2014年第16期1478-1480,共3页China Pharmacy

摘　　要：目的:观察不同剂量醋酸奥曲肽治疗肝硬化食管胃静脉曲张破裂出血的临床疗效和安全性。方法:46例肝硬化食管胃静脉曲张破裂出血患者按随机数字表法均分为观察组和对照组。两组患者均给予常规治疗后,对照组患者给予醋酸奥曲肽0.1mg缓慢静脉推注,再给予醋酸奥曲肽0.3 mg加入5%葡萄糖注射液500 ml中以25μg/h的速度连续静脉滴注,bid;观察组患者给予醋酸奥曲肽0.2 mg缓慢静脉推注,再给予醋酸奥曲肽0.6 mg加入5%葡萄糖注射液500 ml中以50μg/h的速度连续静脉滴注,bid。两组患者疗程均为5 d。观察两组患者的临床疗效,治疗前后门静脉内径(PVD)、门静脉平均流速(PVV),记录需要接受输血的例数、平均输血量、病死率及不良发生情况。结果:观察组患者总有效率显著高于对照组患者,观察组患者接受输血例数和平均输血量均显著低于对照组患者,两组比较差异均有统计学意义(P<0.05);治疗后两组患者PVD均显著低于同组治疗前,PVV均显著高于同组治疗前,差异有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05);两组患者病死率及不良反应发生率比较差异均无统计学意义(P>0.05)。结论:不同剂量醋酸奥曲肽治疗肝硬化食管胃静脉曲张破裂出血均有显著疗效,但高剂量组疗效更好,且安全性相当。OBJECTIVE： To observe the clinical efficacy and safety of different doses of acetic octreotide in treatment of esoph-agogastric varicose hemorrhage in patients with liver cirrhosis. METHODS： 46 liver cirrhotic patients with esophagogastric varicose bleeding were randomly divided into observation group and control group. Both groups received routine treatment. Control group was treated with intravenous push of acetic octreotide 0.1 mg, and then received intravenous dripping of acetic octreotide 0.3 nag added into 5% Glucose injection 500 ml at the rate of 25 μg/h continually, bid. Observation group was treated with intravenous in- fusion of acetic octreotide 0.2 mg, and then received intravenous dripping of acetic octreotide 0.6 mg added into 5 % Glucose injec-tion 500 ml at the rate of 50μg/h, bid, continually. Treatment course of 2 groups lasted for 5 days. Clinical efficacy, PVD and PVV were observed in 2 groups before and after treatment. The case number of blood transfusion, the average amount of blood transfusion, mortality and adverse drug reactions were compared between 2 groups after treatment. RESULTS： The total effective rate of observation group was significantly higher than that of control group. The case number of blood transfusion and the average amount of blood transfusion in observation group were significantly lower than in control group; there was statistical significance （P〈0.05）. After treatment, PVD of 2 groups were significantly lower than before, while Pvv was significantly higher than be- fore; there was statistical significance （P〈0.05） ; but there was no statistical significance between 2 groups （P〉0.05）. There was no statistical significance in mortality and the incidence of ADR between 2 groups （P〉0.05）. CONCLUSIONS： Different doses of octreotide are effective in the treatment of esophagogastric varicose bleeding in patients with liver cirrhosis, but high-dose octreo-tide has better effects and safety.

关 键 词：醋酸奥曲肽 食管胃静脉曲张 出血 肝硬化 疗效 

分 类 号：R571.3[医药卫生—消化系统]