奥曲肽辅助治疗肝癌破裂出血31例观察

目的探讨肝癌合并破裂出血患者应用奥曲肽辅助治疗的临床意义。方法肝癌合并破裂出血患者一经确诊除给予快速输液、应用止血剂、抗休克等常规治疗外，同时给予奥曲肽0．1mg i．v，然后再给予0．5～1．0mg，静脉滴注维持24h。次日根据病情继续滴注或改为0．1 mgi．h q6h，连续应用3～5d。结果本组31例，非手术治疗11例，手术探查20例。1例为全肝癌破裂并大量血性腹水，连续应用奥曲肽等保守治疗12d，发生多器官功能障碍综合症死亡，其余病例病情稳定后顺利出院。结论肝癌合并破裂出血患者应用奥曲肽，能降低门静脉压力，缓解并存的门静脉高压，为尽快渡过急性出血期、稳定病情、进一步采取手术治疗和各种非手术治疗赢得了时间。

Exploration of Octreotide in the Treatment of Liver Cancer Broken with Analysis of 31 Cases

Objective To explore the clinical significance of octreotide in the treatment of liver cancer rupture and bleeding.Methods We gave the patients with liver cancer rupture and bleeding conventional therapy such as fast transfusion,haemostatic,anti-shock as soon as diagnosed,at the same time octreotide 0.1 mg i.v was used,and then gave a continuous infusion of octreotide 0.5-1.0 mg maintain 24 h.The following day,we used octreotide 0.1 mg i.h q6 h or continuous infusion for 3-5 days according as the state of the illness.Results 31 patients in the octreotide group were observed,11 patients received medical treatment and 20 patients received operation.In the group one patient died of rupture of liver cancer and bloody ascites,who received continuous infusion of octreotide and other conventional therapy for 12 days,and presented multiple organ dysfunction syndrome(MODS) finally.Conclusions Gave the patients with liver cancer rupture and bleeding octreotide could reduce the pressure of the portal vein and could gain time for the patients to get through acute bleeding and receive further treatment.