善得定和垂体后叶素联用利其丁治疗食管胃底静脉曲张破裂对比研究

Contrast study of esophageal-gastric fundus variceal bleeding treated with Sandostatin, Pituitrin associated with Regitine

目的 观察善得定对食管胃底静脉曲张破裂出血的治疗效果 ,并与垂体后叶素联用利其丁进行比较 .方法 6 8例患者根据患者入院的先后顺序随机分为 :34例善得定治疗组 ,剂量为首次 0 .1mg静注 ,再以 0 .6 mg· 2 4h· d- 1持续静滴 ;34例垂体后叶素 18U· h- 1联用利其丁 2 mg· h- 1治疗组持续静滴 ,二组均连用 2 d.结果 两组病例 12 h止血率分为 5 2 .9%,2 6 .4%,P<0 .0 1;2 4h止血率分别为 76 .4%,38.2 %,P<0 .0 1;平均出现疗效时间分别为 (5 .2± 3.6 ) h,(10 .2± 3.4) h,P<0 .0 1;平均止血时间分别为 (8.1± 4.2 )h,(16 .9± 3.8) h,P<0 .0 1;2 4h死亡率分别为 2 .9%,5 .9%,P<0 .0 1;1wk总死亡率分别为 8.8%,2 0 .6 %,P<0 .0 1;副作用发生率分别为 11.8%,38.2 %,P<0 .0 1;均有显著性差异 .结论 善得定治疗食管胃底静脉曲张破裂出血的疗效较垂体后叶素联用利其丁满意 .

AIM To compare the effects of Sandostatinon and that of Pituitrin associated with Regitine in treating esophageal-gastric fundus variceal bleeding. METHODS 68 cases with esophageal-gastric fundus variceal bleeding were randomly divided into two groups: 34 cases were treated with Sandostatin alone (S group, 0.1 mg IV followed by 1.2 mg VD for 2 d). Another 34 cases were treated with Pituitrin associated with Regitine (P-R group). Pituitrin was administrated VD at the dosage of 18 U/h and Regitine 2 mg/h IV once a day for 2 days. RESULTS Haemostatic rate of S group and P-R group was respectively 52.9% and 26.4% in 12 h (P<0.01) and 76.4% and 38.2% in 24 h (P<0.01); average haemostatic time was (8.1±4.2) h and (16.9±3.8) h (P<0.01); mortality rate in 24 h was 2.9% and 5.9% (P<0.01) and in l wk was 8.8% and 20.6% (P<0.01). Sandostatin alone (11.8%) had less side effect than Pituitrin associated with Regitine (38.2%) (P<0.01). CONCLUSION Sandostatin alone is more effective and has less side effect in treating esophageal-gastric fundus variceal bleeding than Pituitrin associated with Regitine.