Burroughs A K
University Department of Medicine, Royal Free Hospital and School of Medicine, London, UK.
Dig Dis. 1992;10 Suppl 1:30-7. doi: 10.1159/000171385.
Vasoactive drug therapy is the only therapy that can be administered immediately to patients with suspected variceal bleeding. The optimal agent is not yet available, but somatostatin or octreotide, glypressin and vasopressin and nitroglycerin are the best candidates. Somatostatin and octreotide have the best therapeutic index as they have very few side effects. They compare well to the other agents in comparative randomized trials. In addition to being used prior to sclerotherapy, vasoactive agents may show benefit when used in combination with endoscopic methods and in the immediate interval thereafter in order to prevent early re-bleeding. This remains to be tested in clinical trials.
血管活性药物治疗是唯一可立即用于疑似静脉曲张出血患者的治疗方法。目前尚无最佳药物，但生长抑素或奥曲肽、甘氨加压素、血管加压素和硝酸甘油是最佳选择。生长抑素和奥曲肽的治疗指数最佳，因为它们副作用极少。在比较性随机试验中，它们与其他药物相比效果良好。除了在硬化治疗前使用外，血管活性药物与内镜方法联合使用以及在此后紧接着使用时，可能有助于预防早期再出血。这仍有待临床试验验证。
