硝酸甘油联合垂体后叶素治疗食管胃底静脉曲张破裂出血的疗效观察(附96例报告)

The Curative Effect of Nitronglycerin Plus Pituitrin for Esophageal and Gastric Varicose Blooding

目的:评价硝酸甘油联合垂体后叶素治疗肝硬化并食管胃底静脉曲张破裂出血(Esophagealandgastricvaricosebleeding ,EGVB)的临床疗效。方法:96例EGVB患者分为3组,生长抑素组3 2例用生长抑素先静脉注射2 5 0 μg,再以2 5 0 μg/h的速度持续静脉滴注2d ;垂体后叶素组3 2例先以垂体后叶素0 .2～0. 4U/min持续静脉滴注12～2 4h ,2 4h后减半量为0 1U/min继续维持静脉滴注总共用药2日;垂体后叶素联合硝酸甘油组(联用组) 3 2例在垂体后叶素组治疗的基础上,加用硝酸甘油10mg静脉滴注,10～5 0 μg/min ,用药2d ;观察3组的止血率,不良反应发生率及出血病死率。结果:生长抑素组止血率为78% ( 2 5 / 3 2 ) ;不良反应发生率为9% ( 3 /3 2 ) ;出血病死率为6 % ( 2 / 3 2 )。联用组分别为75 % ( 2 4 / 3 2 )、12 % ( 4 / 3 2 )、9% ( 3 / 3 2 ) ;垂体后叶素组分别为81% ( 2 6 / 3 2 )、4 4 % ( 14 / 3 2 )、12 % ( 4 / 3 2 ) ,3组止血率差异无统计学意义(P >0.0 5 )。生长抑素组、联用组的不良反应发生率与垂体后叶素相比较,差异有统计学意义(P <0 .0 5 )。结论:硝酸甘油联合垂体后叶素治疗EGVB的疗效与生长抑素及垂体后叶素相当,但不良反应小于垂体后叶素,价格低于生长抑素。

Objective:To evaluate the clincal effect of nitroglycerin plus pituitrin on esophageal and gastric varicose bleeding(EGVB).Methods:96 cases of EGVB were divided into 3groups.Group 1(growth inhibin group)was given an injection of 250μg of growth inhibin into the veins each person first,and then given trip of this drug at a speed of 250μg/h on 2 successive days.In group 2(pituitrin group)the pituitrin was dripped by 0.2～0.4U/min on successive12～24 hours,then by 0.1U/min for a total of 2days.Group 3(combined group)was treated with pituitrin plus nitroglycerin through dripping 10mg,10～15μg/min on successive 2 days. The hemostasis rate,adverse effect rate and hemorrhagic fatality rate were in the three groups were observed.Results: The hemostasis rate,adverse effect rate and,hemorrhagic fatality rate were,respectively,78%,9% and 6% in group 1,75%,12% and 9% in group 2,and 81%,44% and 12% in group 3.A statistical comparison between the three groups was not significant with regard to hemostasis rate(P>0.05),and the differences in adverse effect rate and hemorrhagic fatality rate were remarkable between group 1and group 3(P>0.05).Conclusion:Pituitrin plus nitroglycerin is as effective as growth inhibin and pituitrin in treatment of EGVB,and the adverse effect is less than that of pituitrin and the price is lower than that of growth inhibin.