奥曲肽与三腔管单用或联合治疗食管胃底静脉曲张大出血的对比研究

Comparison of the hemostatic efficacy of octreotide,3-cavity tube, and octreotide plus 3-cavity tube in the treatment of hemorrhea of acute esophagogastric varices

目的 :评价单独应用奥曲肽 (商品名 :善宁 )、三腔管或善宁联用三腔管治疗食管胃底静脉曲张大出血的止血效果。方法 :随机分组 ,分别采用善宁 2 5 μg/h持续静滴 72h ,三腔管压迫止血或二者联用 ,通过胃管观察各组的止血效果。结果 :止血总有效率在善宁、三腔管及联合治疗组分别为 87.9% ,83.3%和 90 .7% ,3组间无明显差异 (P >0 .0 5 ) ;即刻止血率在善宁与联合组分别为 70 .7%和 76 .7% ,2组也无明显差异 (P >0 .0 5 ) ,但明显优于三腔管组 (P <0 .0 1) ;再出血率在三腔管组拔管后达 43.0 % ,联合组拔管后仅 7.7% ;善宁组不良反应极少 ,而三腔管和联合组治疗后不良反应及肝硬化并发症明显增多。结论 :善宁可快速有效地控制食管胃底静脉曲张大出血 ,不良反应及并发症少 ,明显优于单用三腔管 ,必要时二者可联合应用。

Objective:To compare the hemostatic efficacy of octreotide,3 cavity tube,and octreotide plus 3 cavity tube in the treatment of hemorrhea of acute esophagogastric varices.Methods:Patients enrolled into the study were randomly divided to receive octreotide 25 μg/h for 72h,or 3 cavity tube,or octreotide plus 3 cavity tube and the hemostatic effects in each group were observed.Results:The total hemostatic rate had no significant difference between groups ( P >0.05) but the immediate hemostatic rate did have significant difference between octreotide containing groups (70.7% and 76.7%) and 3 cavity tube group ( P <0.01) in favour of the former two.The rebleeding rate was 43.0% for 3 cavity tube group after removing tube vs 7.7% in combination group in favour of the latter.Fewer side effects occurred in octreotide group and hepatic cirrhosis and other complications occurred in the other 2 groups.Conclusion:Hemorrhea of acute esophagogastric varices can be rapidly and effectively controlled by octreotide with fewer side effects.Octreotide is obviously superior to 3 cavity tube in treatment of symptom mentioned above. [