施他宁与垂体后叶素应用于老年人食管胃底静脉曲张破裂出血的疗效观察

Therapeutic Effect of Somatostatin and Pituitrin on Esophageal-Gastric Fundus Variceal Bleeding in Aged Patients

目的:观察施他宁与垂体后叶素治疗老年性食管胃底静脉曲张破裂出血的疗效差异。方法:38例2001年至2006年我科收治的年龄≥60岁的老年食管胃底静脉曲张破裂出血患者,按照入院先后顺序随机化分为:施他宁治疗组12例;垂体后叶素治疗组13例;施他宁+垂体后叶素治疗组13例。给药后分别在12 h、24 h及48 h观察药物止血效果,并对输血量、1 w再出血率、副作用发生率及死亡率进行对比。结果:与垂体后叶素组相比,施他宁组(P<0.05)和施他宁+垂体后叶素组(P<0.01)在12 h、24 h及48h止血率均显著增加,副作用发生率明显降低,而施他宁组与施他宁+垂体后叶素组相比并无明显差异(P>0.05)。三组的死亡率、1 w再出血率及输血量均无显著性差异。结论:施他宁对老年性食管胃底静脉曲张破裂出血的疗效优于垂体后叶素,两者联用效果与施他宁单独使用无显著差异。

Objective： To observe the therapeutic effect of Somatostatin and Pituitrin on esophageal-gastric fimdus variceal bleeding in aged patients. Methods： 38 patients with esophageal-gastric fumdus variceal bleeding and age more than 60 years in our hospital from 2001 to 2006 were divided into three groups randomly： somatostatin group （n=12）, pituitrin group （n=13）, and somatostatin ＋ pituitrin group （n=13）. Hemostatic effect at 12 h, 24 h and 48 h was observed after medication, and blood transfusion, incidence rate of lw-haemorrhage, adverse reaction and mortality rate were also compared among the three groups. Results： Hemostatic ratio increased observably at 12 h, 24 h and 48 h in Somatostatin group and Somatostatin＋ Pituitrin group when compared with Pituitrin group, while incidence rate of adverse reaction decreased observably. There were no differences in hemostatic ratio and incidence rate of adverse reaction between the Somatostatin group and Somatostatin＋ Pituitrin group. In addition, there were no differences in mount of blood transfusion, incidence rate of lw-haemorrhage and mortality rate among the three groups. Conclusions： Somatostatin has a better therapeutic efficacy on Esophageal-Variceal Bleeding in aged patients than Pituitrin. The combination of Somatostatin and Pitui^in had no further increase in the therapeutic efficacy.