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长效奥曲肽在控制胃肠道血管发育异常再出血方面有效。

Long-acting octreotide is effective in controlling rebleeding angiodysplasia of the gastrointestinal tract.

作者信息

Orsi P, Guatti-Zuliani C, Okolicsanyi L

机构信息

Chair of Gastroenterology, University of Parma, Italy.

出版信息

Dig Liver Dis. 2001 May;33(4):330-4. doi: 10.1016/s1590-8658(01)80087-6.

Abstract

BACKGROUND

Management of bleeding angiodysplasia of the gastrointestinal tract is often a major clinical problem. Lesions are frequently multiple, not detectable or missed during conventional endoscopy and patients are sometimes at high risk for complications because of advanced age and serious concomitant disorders.

AIMS

To determine the efficacy of a new formulation of somatostatin analogue (octreotide long-acting) in management of recurrent bleeding angiodysplasia in patients resistant to endoscopic treatment and not suitable for surgery.

PATIENTS AND METHODS

Three patients with recurrent bleeding angiodysplasia of gastrointestinal tract were treated with long-acting octreotide administered intramuscularly 20 mg monthly to each individual. The number of admissions for acute bleeding, hospital stay and number of blood units transfused before and after treatment (followup: 15-17 months) were regularly monitored.

RESULTS

In each patient, a relevant decrease in number of hospital admissions, duration of hospital stay, number of administered blood units was seen and mean haemoglobin values significantly increased in all of them after introducing long-acting octreotide therapy.

CONCLUSIONS

This is the first report on use of long-acting octreotide in bleeding angiodysplasia of gastrointestinal tract. Data suggest that long-acting octreotide is a safe drug and is successful in controlling recurrent gastrointestinal bleeding due to angiodysplasia in elderly patients not eligible for surgical or endoscopic therapy.

摘要

背景

胃肠道出血性血管发育异常的管理常常是一个重大临床问题。病变通常为多发性,在传统内镜检查时难以发现或被遗漏,而且由于患者高龄及严重的合并症,有时会面临较高的并发症风险。

目的

确定一种新的生长抑素类似物制剂(长效奥曲肽)在治疗对内镜治疗耐药且不适合手术的复发性出血性血管发育异常患者中的疗效。

患者和方法

3例胃肠道复发性出血性血管发育异常患者接受了长效奥曲肽治疗,每人每月肌肉注射20毫克。定期监测治疗前后(随访15 - 17个月)急性出血的住院次数、住院时间和输血单位数。

结果

在引入长效奥曲肽治疗后,每位患者的住院次数、住院时间和输血单位数均显著减少,且所有患者的平均血红蛋白值均显著升高。

结论

这是关于长效奥曲肽用于胃肠道出血性血管发育异常的首次报告。数据表明,长效奥曲肽是一种安全的药物,对于不适合手术或内镜治疗的老年患者,能成功控制因血管发育异常引起的复发性胃肠道出血。

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