善得定和善得定联用奥美拉唑治疗门脉高压性胃病急性出血的对照研究

目的 :验证善得定、善得定联用奥美拉唑治疗肝硬化门脉高压性胃病 ( PHG)上消化道出血的临床疗效。方法 :将 74例经胃镜证实为肝硬化门脉高压性胃病上消化道出血的患者随机分为两组 ,分别给予善得定和善得定联用奥美拉唑 (联合用药组 )治疗 ,通过鼻胃管抽吸胃内容物观察出血情况 ,进行对照研究。并记录患者的输血量和药物的不良反应。结果 :善得定组 6 h、2 4 h、4 8h的完全止血率与联合用药组差异无显著性 ( P>0 .0 5) ,但善得定组 12 h的完全止血率显著低于联合用药组 ( 78.9% ,P<0 .0 2 5)。善得定 2 4 h内完全止血平均所需时间为 ( 11.0 4± 6 .96 ) h,显著高于联合用药组 ( 6 .81± 4 .0 5) h,( P<0 .0 5) ;善得定组和联合用药组治疗后 7d的再出血率和生存率差异无显著性( P>0 .0 5) ;善得定组和联合用药组不良反应发生分别为 2例和 1例 ,均无严重不良反应 ,无显著性差异。结论 :善得定能有效、安全控制肝硬化 PHG出血 ,但善得定联用奥美拉唑 ,控制出血比单用善得定更为快速 ,效果更佳

Controlled study of sandostatin and sandosatin combined with pantoprazole on accute gastrointestinal bleeding from PHG

Objective:To assess the efficacy of sandostatin and sandostatin combined with pantoprazole (sandostatin-pantoprazole)on acute upper gastrointestinal bleeding from portal hypertensive gastropathy(PHG) in ptients with cirrhosis.Methods:74 PHG in cirrhosis patients with acute bleeding comfirmed by endoscopy were randomly divided into 2 groups and administered with sandostatin and sandostatin-pantoprazole for 48 h respectively.The stomach tubes were placed in the stomach before the treatment,and the duration of hemostatsis,volume of transfusion,rebleeding and shor-term survival period.Results:After 6 h?24 hand 48 h treatment,the hemostatic rates in sandostatin group and in sandostatic rates in sandostatin group and in sandostatin-pantoprazole group showed no significant differences( P >0.05).But after 12 h treatment,the hemostatic rate in sandostatin group was 38.9 %,significantly lower than that in sandostatin-pantoprazole group (78.9 %, P <0.05).After 24 h treatment,the mean duration of cesstation of bleeding in sandostatin-pantoprazole group was (6.81±4.05) hrs,significantly shorter than that in sandostatin group(11.04±6.96 hrs, P <0.05).The quantity of blood transfusion in sandostatin pantoprazole group was siginficantly less than that in sandostatin group( P <0.05).But there were no significant differences in the rates of rebleeding.survival period and adverse effects between the two group.Conclusion:This study suggests that sandostatin is a safe and effective treatment of acute bleeding from PHG,and sandostatin combined with pantoprazole can control PHG bleeding more effectively and rapidly.