奥曲肽治疗晚期血吸虫病食管胃静脉曲张大出血的疗效

THE EFFECT OF OCTREOTIDE IN TREATMENT OF MASSIVE GASTROESOPHAGEAL VARICEAL HEMORRHAGE DUE TO ADVANCED SCHISTOSOMIASIS

目的对奥曲肽（Octreotide）治疗晚期血吸虫病食管、胃静脉曲张大出血的疗效作出评价。方法将96例病人分为3组，A组32例，用垂体后叶素0．2u／min静脉持续注射，24h后减半剂量连续用3d。B组34例，垂体后叶素的用法同A组，同时加用硝酸甘油10～40μg／min持续静脉注射4d。C组30例，用奥曲肽100μg静脉注射后，以25μg／h的速度持续静脉注射，24h后减半剂量维持1d。结果3组止血率，分别为56．2％（18／32）、50．0％（17／34）及86．7％（26／30），C组明显优于A组与B组（P＜0．05）。3组止血有效的病例停药后1周内的再出血率，分别为2／18、2／17及5／26，无显著差异（P＞0．05）。结论奥曲肽的疗效明显优于垂体后叶素及硝酸甘油。

Objective To assess the effect of octreotide in treatment of massive gastro-esophageal variceal hemorrhage due to advanced schistosomiasis. Methods 96 patients with ad-vanced schistosomiasis were divided into three groups. In group A patients (n=32), pituitrin(0.2u/min) was given for one day by continuously intravenous administration, and then pituitrin(0.1u/min) was given for 3 days. In group B patients (n=34), pituitrin administration was similaras group A, in addition, nitroglycerin (10～40μg/min) was given for 4 days by intravenous admin-istration. In group C patients (n=30) octreotide 100μg was given intravenous at first, then oc-treotide (25μg/h) was given for one day by continuously intravenous administration,and then oc-treotide (12.5μg/h) was given for one day. Results The rates of efficiency in controlling bleedingin group A, B and C were 56.2% (18/32), 50.0% (17/34) and 86.7%(26/30) respectively. Thegroup C was evidently superior to group A and group B (P<0.05). However,within a week aftertreatment, the rates of rebleeding in the A, B and C groups were 2/18, 2/17 and 5/26 respectively.There were no significant differences (P>0.05). Conclusion Octreotide is superior to pituitrin andpitutrin plus nitroglycerin in treatment of massive variceal hemorrhage due to advanced schistosomi-asis.