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目的探讨加倍剂量生长抑素治疗肝硬化食管胃底静脉曲张破裂出血(esophagogastric variceal bleeding,EVB)的临床效果及安全性。方法 EVB患者102例,随机分为观察组和对照组各51例。对照组静脉注射生长抑素250μg后给予生长抑素250μg/h持续泵注,观察组静脉注射生长抑素500μg后给予生长抑素500μg/h持续泵注,2组均连续治疗5d。比较2组首次止血成功率、再出血率、治疗有效率及不良反应发生率,随访6周记录死亡情况。结果观察组首次止血成功率(88.24%)、治疗有效率(86.27%)均高于对照组(68.63%、66.67%),再出血率(15.69%)低于对照组(33.33%)(P<0.05);观察组不良反应发生率(21.57%)、入院6周内病死率(11.76%)与对照组(11.76%、21.57%)比较差异均无统计学意义(P>0.05)。结论加倍剂量生长抑素治疗肝硬化EVB安全有效,可降低再出血率,且不增加不良反应发生率和入院6周内病死率。
Objective To investigate the clinical efficacy and safety of doubled dose of somatostatin in the treatment of esophagogastric variceal bleeding (EVB). Methods 102 patients with EVB were randomly divided into observation group and control group, 51 cases each. The control group was given somatostatin 250μg intravenously soaking with 250μg / h continuous infusion, the observation group was injected with somatostatin 500μg intravenously solated somatostatin 500μg / h continuous pump, two groups were treated for 5 days. The success rate of hemostasis, rebleeding rate, treatment efficiency and incidence of adverse reactions in the two groups were compared. The deaths were recorded 6 weeks after follow-up. Results The success rate of the first hemostasis was 88.24% in the observation group and 86.27% in the control group (68.63%, 66.67%), and the rate of rebleeding was 15.69% (33.33%) in the observation group (P < 0.05). The incidence of adverse reactions in the observation group (21.57%) was not significantly different from that in the control group (11.76%, 21.57%) in the 6 weeks after admission (11.76%) (P> 0.05). Conclusions Doubled dose of somatostatin in the treatment of cirrhosis of the liver is safe and effective, which can reduce the rate of rebleeding without increasing the incidence of adverse reactions and the case fatality within 6 weeks.