加倍与常规剂量奥曲肽治疗肝硬化食管静脉曲张破裂出血

目的 :研究加倍与常规剂量奥曲肽治疗肝硬化食管静脉曲张破裂出血的疗效。方法 :肝硬化食管静脉曲张破裂出血病人 4 3例次 (男性 2 8例次 ,女性 15例次 ) ,年龄 5 6a±s 14a。分常规剂量 (10 0μg ,iv ,继以 2 5 μg·h- 1静脉滴注维持 )组 33例次 ,加倍剂量 (10 0 μg ,iv ,继以 5 0 μg·h- 1静脉滴注维持 )组 10例次。结果 :加倍剂量组与常规剂量组的止血率分别为 90 % (9/ 10 ) ,76 % (2 5 / 33) ,2组之间差异无显著意义 (P >0 .0 5 ) ;其中 5例次应用常规剂量无效者改用加倍剂量后出血得到控制。肝功能分级与奥曲肽的止血率之间差异无显著意义 (P >0 .0 5 )。结论 :奥曲肽是治疗肝硬化食管静脉曲张破裂出血的有效药物。常规剂量无效者改用加倍剂量仍可获得较好的止血效果

Conventional and double dose octreotide for esophageal variceal hemorrhage in patients with liver cirrhosis

AIM: To assess the effect of octreotide for esophageal variceal hemorrhage with conventional and double dose. METHODS: Forty-three cirrhotic patients with esophageal variceal hemorrhage (M 28, F 15; 56 a±s 14 a) were divided into conventional dose group and double dose group. Thirty-three patients of conventional dose group received octreotide(at a rate of 25 μg·h -1 intravenous infusion continually) and ten patients of double dose group received that(at a rate of 50 μg·h -1 intravenous infusion continually) followed an initial bolus 100 μg injection. RESULTS: The bleeding control rates of conventional group and double dose group within 24 h were 76%(25/33), 90%(9/10), respectively. There were no significant differences between them (P> 0.05). Five patients whose bleeding was not controlled with conventional dose were changed to use double dose and the bleeding was controlled. There were no statistical differences in the bleeding control rates among the Child-Pugh grades(P> 0.05). No obvious adverse reactions were observed either in conventional dose group or double dose group. CONCLUSION: Octreotide is an effective and safe drug for esophageal variceal hemorrhage. It can be effective with double dose when the bleeding is not controlled with conventional dose.