大剂量生长抑素治疗顽固性食管静脉曲张破裂出血

目的观察大剂量生长抑素治疗顽固性食管静脉曲张破裂出血的临床疗效。方法选择经常规剂量生长抑素治疗6 h仍出血不止的89例食管静脉曲张破裂出血的患者,随机分为2组。对照组(n=45):继续采用常规剂量生长抑素(250μg/h)静脉微量泵泵入维持注射;治疗组(n=44):采用大剂量生长抑素(500μg/h)静脉微量泵泵入维持注射,连用5 d。结果治疗组有效率86.36%,对照组有效率62.22%,两组比较,差异有统计学意义(P<0.05);两组患者1周内再出血率:治疗组(11.36%)低于对照组(15.56%),但两组比较,差异无统计学意义(P>0.05)。结论对顽固性食管静脉曲张破裂大出血患者,常规剂量生长抑素治疗效果不佳时加大剂量,治疗效果显著提高。

Clinical effects of high dose somatostatin in the treatment of intractable esophageal variceal bleeding

Objective To investigate the efficacy of high dose somatostatin in the treatment of intractable esophageal variceal bleeding(EVB).Methods 89 EVB patients who nonresponders to the usual dose somatostatin treatment within the first 6 h were randomly divided into two groups:treatment group(n=44) and control group(n=45).Patients in control group received usual dose somatostatin by continuous intravenous pump at a constant speed of 250 μg/h,and patients in treatment group were given high dose somatostatin(500μg/ h) for 5 days.Results The effective rate in treatment group was 86.36%,while it was 62.22% in control group(P<0.01).The rate of early rebleeding in the treatment group(11.36%) was similar to that in control group(15.56%)(P>0.05).Conclusion In nonresponders to usual dose somatostatin,high dose of somatostatin significantly increased the control rate of intractable esophageal variceal bleeding.The treatment of high dose somatostatin may be an alternative when standard somatostatin fails.