奥曲肽治疗门静脉高压性上消化道出血

Octreotide in the treatment of portal hypertension with upper gastrointestinal bleeding

目的观察奥曲肽治疗门静脉高压性上消化道出血的临床疗效。方法选择我院确诊的门静脉高压性上消化道出血患者90例,随机分为治疗组53例和对照组37例。治疗组应用奥曲肽0.1 mg加入生理盐水20 mL静脉注射后,奥曲肽0.3 mg加入5%葡萄糖60 mL或生理盐水60 mL中,5mL/h微量泵持续泵入,患者出血停止后减量维持24～48 h;对照组给予垂体后叶素0.2μg/min、硝酸甘油50μg/min持续微量泵入,观察出血停止后减量维持24～48 h。结果治疗组24 h出血停止35例,72 h出血停止16例,总有效率96%;对照组24 h出血停止19例,72 h出血停止11例,总有效率81%,治疗组总有效率明显优于对照组,差异有统计学意义(P<0.05)。结论奥曲肽对门静脉高压性上消化道出血疗效显著。

Objective To evaluate the effect of octreotide in the treatment of portal hypertension with upper gastrointestinal bleeding. Methods Ninty cases were randomly divided into two groups：the treatment group with 53 cases and control group with 37 cases. Treatment group was first given an intravenous injection with 0.1 mg octreotide in 20 mL NS ,then pumped another 0.3 mg oetreotide in 60 mL 5% Glucose solution or 60 mL NS by consecutive intravenous infusion with the speed of 5 mL per hour ,reduction was maintained for 24 to 48 hours after stopping bleeding, while control group was consecutive pumped with Neurohypophyseal Hormones and Nitroglycerin with the speed of 0.2/min and 50g/min seperately, reduction was maintained for 24 to 48 hours after stopping bleeding. Results 35 cases stopped bleeding within 24 hours, and 16 cases within 72 hours in treatment group.The total effective rate was 96%. 19 cases stopped bleeding within 24 hours and 11 cases within 72 hours in control group, the total effective rate was 81%. Statistically significant differences （P 〈 0.05 ）were found between two groups. Conclusion Oetreotide is an effective treatment for portal hypertension with upper gastrointestinal bleeding