小剂量垂体后叶素联用硝酸甘油治疗食管胃底静脉曲张破裂出血疗效观察

The effect observation on treatment of esophageal gastrom varicosis rupture hemorrhage with low dose vasopressin and nitroglycerin

目的对小剂量垂体后叶素联用硝酸甘油治疗食管胃底静脉曲张破裂出血疗效作出评价。方法89例食管胃底静脉曲张破裂出血患者随机分成三组,A组31例,用小剂量垂体后叶素(0.1u/min)和硝酸甘油(20μg/min)联合治疗;B组30例,单用垂体后叶素(0.2u/min)治疗;C组28例,联用小剂量垂体后叶素(0.1u/min)、奥曲肽治疗(0.25μg/min)。结果三组止血率分别为83.8%(26/31)、60%(18/30)、82.1%(23/28)。经统计,垂体后叶素联用硝酸甘油治疗较单用垂体后叶素有显著性差异(χ2=4.32,P<0.05),而与较小剂量垂体后叶素、奥曲肽联用无显著性差异(χ2=0.02,P>0.05)。止血有效病例停药6d后再出血率分别为4/26、3/18、3/23,无明显差异。结论!!垂体后叶素联用硝酸甘油有显著降低门脉压力的作用,疗效显著。

Objective!To assess the effect of low dose vasopressin and nitroglycerin in treatment of esophageal gastrom varicosis rupture hemorrhage. Methods!89 patients with esophageal gastrom varicosis rup- ture hemorrhage were divided into three groups randomly. In group A patients(n=31),were treated with low dose vasopressin(0.1u/ min) and nitroglycerin (20μg/ min). In group B patients (n=30),with single vasopressin (0.2u/min). In group C patients (n=28), with low dose vasopressin (0.1u/ min) and low dose octreotide (0.25μg/min). Results The control rates of bleeding were 83.8%(26/ 31),60%(18/ 30),82.1%(23/ 28) respec- tively. By χ2 test ,the combined therapy group (vasopressin and nitroglycerin) was significant different from vasopressin group (P<0.05, χ2=4.32), but not from combined therapy group (nitroglycerin. and octreotide) (P>0.05, χ2=0.02) . However, within six days after treatment, the rates of rebleeding in the A, B and C groups were no significant different (P>0.05) . Conclusion!The results indicate that the combination of vaso- pressin and nitroglycerin can significantly reduce portal hytertetion, obtained and eminent curative effection.