生长抑素治疗食管胃底静脉曲张破裂出血的临床研究  

Clinical Study on Effect of Somatostatin in Treatment of Esophageal Variceal Bleeding

作　　者：鲁敏[1] 张建丰[1] 秦兴雷[2] 李宵[1] 石景森[2] 王作仁[2] 王林[2] 

机构地区：[1]洛阳市中心医院内科,河南洛阳471009 [2]西安交通大学第一医院,陕西西安710061

出　　处：《洛阳医专学报》2003年第1期17-19,共3页Journal of Luoyang Medical College

摘　　要：目的 探讨生长抑素治疗食管胃底静脉曲张破裂出血的临床效果。方法 应用奥曲肽治疗食管胃底静脉曲张破裂出血患者41例,并与垂体后叶素治疗的32例及三腔管治疗的25例进行对照。观察3组平均止血时间、24h止血率以及治疗前后门静脉主干直径、血流速度、血流量的变化。结果 奥曲肽治疗组、垂体后叶素治疗组、三腔管治疗组平均止血时间分别为194.27±28.88min、358.11±151.43min、134.71±32.12min,24h止血率分别为63.41％、37.50％、72％。奥曲肽治疗组止血率显著高于垂体后叶素治疗组(P<0.01)。奥曲肽治疗前后门静脉内径分别为10.86±0.41mm、13.84±0.35mm,二者有显著差异。奥曲肽治疗后其门静脉血流速度,血流量与治疗前相比较也有显著差异(P<0.01,P<0.05)。结论 奥曲肽能使门脉内径相对缩小、血流量减少和血流速度加快,从而使门脉压力降低达到止血的目的。Objective To evaluate the effects of Somatostatin in the treatment of hemorrhage due to rupture of esophageal varicose vein and varices of fundus of stomach. Methods We used octreotide-an analogue of soma-tostatin to treat 41 cases of hemorrhage from esophageal varices and varices of fundus of stomach. Results were compared with that of 32 patients treated with pituitrin in the therapeutic group, and 25 cases treated three-chambered tube in the control group. Mean stop bleeding and blood flow before and after treatment were quantitatively analyzed in three groups. Result Mean arresting bleeding time in the octreotide group, the pituitrin group and the three-chambered tube group were 194.2±28.88min,358.11 ± 151.43min,134.71 ±32.12min respectively;and corresponding rates of 24 hour arresting bleeding were 63.41% ,37.50%and 72% respectively. Rate of arresting bleeding in the octreotide group was higher than that in the pituitrin group ( P < 0.01) . Main pylic diameter before and after octreotide treatment were 10.86 ± 0.41mm and 13.84 ± 0.35mm respectively , there wene obvious differences before and after octreotide treatment(P<0.01,P<0.05). Conclusion Octreotide may reduce pylic diameter ,lessen blood flow and accelerate blood flow rate so that it decreases portal venous pressure to stop bleeding.

关 键 词：生长抑素 治疗 食管胃底静脉曲张破裂出血 临床研究 奥曲肽 垂体后叶素 三腔管 门脉高压症 

分 类 号：R657.3[医药卫生—外科学] R977.1[医药卫生—临床医学]