善得定治疗癌性上消化道出血临床观察

CLINICAL OBSERVATION OF SANDOSTATIN IN THE TREATMENTOF CARCINOMATOUS HEMORRHAGE OF UPPER DIGESTIVE TRACT

目的为观察善得定治疗恶性肿瘤所致上消化道出血的疗效及副作用。方法选用恶性肿瘤所致上消化道出血６６例．随机分为喜得定治疗观察组和垂体后叶素对照组，治疗观察组患者先用善得定 ０． １ｍｇ＋０．９％ ＮＳ ２０ｍｌ静推，后用善得定以每 ｈ２５ｇ滴速静滴维持２４～４８ｈ，对照组用垂体后叶素以 ２～５Ｕ／ｈ滴速静滴维持２４～４８ｈ。同时给硝酸甘油 ０． ５ｍｇ舌下含服。结果治疗观察组总有效率为８８．２３％（３０／３４），对照组总有效率为６２．５０％（２０／３２），两组差异有显著意义（Ｐ＜０．０５），治疗观察组每例平均输血量为（７００．８０±３２７．１８）ｍｌ，对照组输血量平均每例为（１１７６ ００±３４２． １２）ｍｌ，两组差异有高度显著性（Ｐ＜０ ．０１）。两组均无严重副作用。结论癌性上消化道出血是晚期肿瘤常见并发症及致死原因之一，善得定较传统的垂体后叶素治疗具止血快、止血率高、副作用少优点，且可减少输血量，值得临床广泛推广使用。

Objective To observe the therapeutic effect and the sidereaction of Sandotatin in the treatment of hemorrhage of upper digestive tract caused by malignant tumor. Method 66 cases withhemorrhage of upper digestive tract caused by malignant tumor wererandomly divided into Sandostatin therapeutic group and the pitressincontrol group. Tile therapeutic group were first given Sandostatin 0. ling+ 0. 9 % N. S. 20ml IV, then received continuous intravenous drip 2~5Uper hour for 24- 48h. In the control group, pitressin wad given 2 ~ 5Uper hour by continuous drip for 24-- 48h. Meanwhile the control groupwere given nitroglycerin 0. 5mg sublingllally. Result The effectiverate of the therapeutic group was 88. 23 % (30/34) and that of the control group was 62. 5% (30/32) showing significant difference (PRO. 05). In the therapeutic group, the average amount of blood transfusion of each case was 700. 80 327. 18ml, and it was 1176. 00 342. 12ml in the control group again with significant difference (P<0. 001 ). Neithergroups showed serious side effect. Conclusion Carcinomatous hemorrhageof upper digestive tract is one of the common complications and lethalcauses in the late stagee cancer. Sandostatin has dominance of highspeed hemostasis, high hemostatic rate and low side effect. And it canreduce the amount of blood transfusion. So it should become a widelyused clinical method.