Saari A, Klvilaakso E, Inberg M, Pääkkönen M, Lahtinen J, Höckerstedt K, Schröder T
First Department of Surgery, Helsinki University Central Hospital, Finland.
Am J Gastroenterol. 1990 Jul;85(7):804-7.
Somatostatin (ST) and vasopressin (VP) infusions were compared in the treatment of actively bleeding esophageal varices. Fifty-four patients with liver cirrhosis were included in the study. Thirty-two were given ST 4.2 micrograms/min, and 22 patients were given VP 0.4 IU/min for 72 h after endoscopic diagnosis. The role of alcoholic cirrhosis was similar in both groups. Initial control of bleeding was achieved significantly more often (p = 0.0281) when ST was used (84.4%) than during VP treatment (57.1%). Rebleeding occurred in 18.8% and 4.8%, respectively. Side effects of treatment were significantly more common when VP was used than during ST treatment (p = 0.0021). Overall mortality was high in both groups, being 34% in the ST group and 36% in the VP group. ST infusion seems to be more effective and safer than VP in the treatment of acute variceal bleeding. However, the high frequency of rebleeding during ST treatment means that, after primary hemostasis with ST infusion, other methods, such as surgery or sclerotherapy, are needed to prevent the serious complications of rebleeding.
比较了生长抑素（ST）和加压素（VP）输注在治疗活动性食管静脉曲张出血中的效果。54例肝硬化患者纳入本研究。内镜诊断后，32例患者以4.2微克/分钟的速度输注ST，22例患者以0.4国际单位/分钟的速度输注VP，持续72小时。两组中酒精性肝硬化的作用相似。使用ST时（84.4%），出血的初始控制显著比VP治疗时（57.1%）更常见（p = 0.0281）。再出血发生率分别为18.8%和4.8%。使用VP时治疗的副作用比使用ST时显著更常见（p = 0.0021）。两组的总体死亡率都很高，ST组为34%，VP组为36%。在治疗急性静脉曲张出血方面，ST输注似乎比VP更有效、更安全。然而，ST治疗期间再出血的高发生率意味着，在用ST输注实现初步止血后，需要其他方法，如手术或硬化疗法，以预防再出血的严重并发症。
