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我们应用奥曲肽(Sandostatin,Octreotide,善得定)联用洛赛克(Losec,瑞典Astra公司生产)治疗食道静脉曲张破裂出血20例,疗效显著,报道如下。 1 材料和方法 1.1 病例选择 20例患者均因呕血、暗红色便或黑便即急性上消化道出血而收住者,且均于入院后3日内行内镜检查证实为食道静脉曲张破裂出血。其中男17例,女3例;年龄36～64岁,平均50岁。肝炎后肝硬变11例,酒精性肝硬变8例,原因不明肝硬变1例。肝功能情况按Child-pugh分级:A级4例,B级13例,C级3例。出血后出现头晕、晕厥、出冷汗、脉率增快等低血容量者8例,出现肝性脑病6例。首次出血16例,两次以上出血4例。 1.2 方法 奥曲肽治疗的初始剂量为0.1mg加10％葡萄糖20ml静脉推注(不少于5分钟),继而以0.2～0.4mg加10％葡萄糖500ml持续静脉滴注(25～50μg/h),24小时内总量0.6～0.7mg,用药2～3天,出血停止后维持1～2天。洛赛克40mg静脉注射,每日2次。连续5～10天后改为20mg,每日2次口服。
We applied octreotide (Sandostatin, Octreotide, good set) combined with Losec (Losec, Sweden Astra company) treatment of esophageal variceal bleeding in 20 cases, the effect is significant, are reported below. 1 Materials and Methods 1.1 Case Selection 20 patients were due to hematemesis, dark red or black is the case of acute upper gastrointestinal bleeding and admitted to hospital within 3 days after endoscopy confirmed as esophageal variceal bleeding. There were 17 males and 3 females, aged from 36 to 64 years, with an average of 50 years. Posthepatitis cirrhosis in 11 cases, alcoholic cirrhosis in 8 cases, unknown liver cirrhosis in 1 case. Liver-function classification according to Child-pugh: A grade in 4 cases, B grade in 13 cases, C grade in 3 cases. Bleeding after dizziness, syncope, a cold sweat, pulse rate and other hypovolemia in 8 cases, 6 cases of hepatic encephalopathy. The first bleeding in 16 cases, more than two cases of bleeding in 4 cases. 1.2 Methods Octreotide treatment of the initial dose of 0.1mg plus 10% glucose 20ml intravenous injection (not less than 5 minutes), followed by 0.2 ~ 0.4mg plus 10% glucose 500ml continuous intravenous infusion (25 ~ 50μg / h), 24 The total amount of 0.6 ~ 0.7mg hours, medication 2 to 3 days to maintain the bleeding after 1 to 2 days. Losec 40mg intravenously, 2 times a day. Continuous 5 to 10 days later changed to 20mg, 2 times a day orally.