奥曲肽降低食管曲张静脉压力及减少硬化剂注射针孔出血的临床研究

EFFECT OF REDUCING PRESSURE ON INTRA-OESOPHAGEAL VARICES AND DECREASING HEMORRHAGE DURING SCLEROTHERAPY WITH OCTREOTIDE

１０例肝硬化食管静脉曲张患者内镜直视下硬化剂注射针穿刺入曲张静脉内直接测压，继而外周静脉内推注奥曲肽（Ｏｃｔｒｅｏｔｉｄｅ）０．ｌｍｇ，测定其后１０分钟曲张静脉内压力变化。２０例患者静脉注射奥曲肽０．１ｍｇ，约１０分钟后行食管曲张静脉内硬化剂注射治疗，观察注射针孔出血情况并与２６例单纯硬化剂注射组作比较。结果表明奥曲肽静脉注射后１分钟内，所有用者均有效地降低曲张静脉内压力，１０分钟内平均降低５１％（１８．６５ｍｍＨｇ）。注射奥曲肽组曲张静脉硬化剂注射针孔出血较对照组明显减少（Ｐ＜０．０１）。本研究结果表明，奥曲肽能迅速有效地降低曲张静脉内压力，有利于控制食管静脉曲张急性出血；奥曲肽减少曲张静脉穿刺针孔出血可提高硬化剂注射治疗安全性。

ntra-Oesophageal Variceal Pressure(IOVP) was continuously measured through sclero-therapy needle for l0 minutes before the injection of sclerosants in l0 patient.Right afterthe puncture,a blous of 0.lmg octreotide was given via a peripheral vein.IOVP of all casesdropped with an average decrease of 51%(2.48kPa, P<0.0. A total of 20 cases was givensclerosant l0 minutes after blous injection of 0.lmg octreotide(including the bforementioned10 cases with measurement of IOV). Bleeding from the puncture hole after withdrawal of theneedle was much less in the octeotide treated group as compared with 26 cases withoutoctreotide adminstration(P< 0.01).Based upon the present study, we concluded thatocteotide could reduce IOVP effectively that was of course beneficial in the control ofoesophageal variceal bleeding,and also rendered the practice of sclerotherapy a saferprocedure.