奥曲肽治疗食管静脉曲张内镜下套扎术后早期再出血的临床疗效研究

目的:观察食管静脉曲张患者在接受内镜下曲张静脉套扎术后注射奥曲肽预防曲张静脉早期再出血的疗效。方法:84例肝硬化伴活动性出血或具有最近出血征象的食管静脉曲张患者随机分为内镜下曲张静脉套扎单一治疗组4 2例,奥曲肽和套扎联合治疗组4 2例(奥曲肽50 μg静脉注射,随后2 5μg/h静脉点滴3d)。结果:30d内单一治疗组发生再出血1 7例,其中1 6例发生在4 8h内,再出血率为1 7/42 ( 4 0 % ) ,联合治疗组发生再出血4例,均在4 8h内,再出血率为1 0 % ( 4 /42 ) (P <0 . 0 5)。结论:奥曲肽可以显著减少食管静脉曲张破裂出血患者内镜下曲张静脉套扎术后早期再出血率。

A Study of Clinical Efficacy of Octreotide on the Early Recurrent Bleeding after Ligation in the Treatment of Esophageal Varication

Objective:To observe the effect of octreotide in prevention of early recurrent bleeding after ligation under endoscope and treatment of esophageal varication with octreotide. Methods: 84 patients with cirrhosis and acute or recent esophageal variceal bleeding were randomly divided into alone theropy group (endoscopic variceal ligation) and combined therapy group (octreotide and endoscopic variceal ligation)(octreotide 50μg intravenous injection,later 25μg/h intravenous injection,three days).Results:In ligation alone therapy group recurrent bleeding occured in 17 patients in 30 days,among them 16 patients recurrently bleeded in 48 hours,rates of recurrent bleeding were 40%(17/42).In the combined therapy group recurrent bleeding occured in 4 patients ,all in 48 hours,rates of recurrent bleeding were 10%(4/42),( P <0.05).Conclusion: Octreotide can obviously decrease the rates of early recurrent bleeding of esophageal varication after ligation.