生长抑素在肝硬化上消化道出血中的临床应用

Clinical application of somatostatin in upper gastrointestinal bleeding caused by cirrhosis

目的观察长效生长抑素类似物善得定在肝硬化所致上消化道出血中的疗效及不良反应。方法选取淮阴医院2009年至2011年间患有肝硬化并上消化道出血的患者66例为研究对象,随机分为观察组和对照组,观察组采用静脉注射善得定0.1 mg,后用善得定加5%葡萄糖注射液,以25μg/h维持24～48 h滴注;对照组用垂体后叶素加10%葡萄糖注射液,以2～5 U/h维持24～48 h滴注,同时给予硝酸甘油0.5 mg含服。结果观察组总有效率达93.75%,与对照组相比显著提高,两组比较差异有统计学意义(P<0.01)。两组均有患者出现恶心、腹胀等症状,观察组发生例数较对照组少,且症状较轻。结论生长抑素类似物善得定治疗肝硬化上消化道出血疗效良好,值得临床上广泛推广使用。

Objective To observe the effect of long-acting somatostatin analogue Sandostatin on gastrointestinal bleeding caused by cirrhosis of the liver and the adverse reactions. Methods From 2009 to 2011, 66 cases of upper gastrointestinal bleeding caused by cirrhosis were randomly divided into observation group and control group. The patients in observation group were treated with intravenous injection of Sandostatin 0. 1 mg, then Sandostatin added 5% glucose was injected to maintain 24- 48 h at 25 ixg/h, the patients in control group were given pituitrin added to 10% glucose, 2-5 U/h to maintain 24-48 h, and Ni- troglycerin 0.5 mg was sublingual taken. Results The total effective rate was 93.75% in observation group, which was signifi- cantly higher than that of the control group, the difference was significant （ P 〈 0.01 ）. Patients in both groups had the symptoms such as nausea, bloating, but the numbers were less and the symptoms were mild in observation group. Conclusion The effect of somatostatin analogue Sandostatin on upper gastrointestional bleeding caused by liver cirrhosis is good, is worth to be widely pop- ularized in clinic.