内镜下结扎术联合奥曲肽,垂体后叶素急诊治疗食管静脉曲张破裂出血

Emergency Treatment of Esophageal Varices Bleeding with Endoscopic Variceal Ligation Combined with Octreotide and Pituitrin

目的评价内镜下结扎联合奥曲肽、垂体后叶素治疗食管静脉曲张破裂出血的临床疗效及安全性。方法将食管静脉曲张破裂出血患者52例分成两组,奥曲肽组的28例予奥曲肽50ug/min匀速静滴后再行内镜下结扎术,垂体后叶素组的24例则予96u匀速静滴24小时后行内镜下结扎术。结果两组急诊止血率均为100%,奥曲肽近期内再出血(治疗后一周内)发生率为7%(2/28),垂体后叶素组为16.6%(4/24),两者比较差异有统计学意义(P<0.05)。平均止血时间奥曲肽组为(6.8±4.2)小时,垂体后叶素组为(15.3±13.5)小时(P<0.05),两组均无近期死亡的病例。结论①内镜下结扎术联合奥曲肽或垂体后叶素治疗食管静脉曲张破裂出血止血效果确切;②联合应用奥曲肽近期内再出血发生率明显低于联合应用垂体后叶素且平均止血时间亦明显缩短;③使用奥曲肽能使出血停止或明显减少,使内镜结扎治疗时视野清晰,增加操作的成功率。

Objective To evaluate the clinical efficacy and safety of endoscopic variceal ligation combined withOctreotide and Pituitrin in the treatment of esophageal varices bleeding. Methods 52 patients with esophagealvariceal bleeding were randomly divided into two groups (Octreotide group and Pituitrin group); 28 patients weretreated with endoscopic variceal ligation after the patients were given Octreotide by intravenous infusion ata constant rate of 50ug per minute, the others were treated with endoscopic varice...