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持续静脉输注奥曲肽治疗儿童门静脉高压性上消化道出血:一项来自儿科重症监护病房的观察性研究

Continuous octreotide infusion for treatment of upper gastrointestinal bleeding due to portal hypertension in children: An observational study from pediatric intensive care unit.

作者信息

Koul P B, Totapally B R, Raszynski A

机构信息

Division of Pediatric Critical Care Medicine, Department of Pediatrics, College of Medicine, University of Florida, and Wolfson Children Hospital, Jacksonville, FL, USA.

Division of Critical Care Medicine, Miami Children's Hospital, Miami, FL, USA.

出版信息

J Pediatr Intensive Care. 2012 Jun;1(2):99-103. doi: 10.3233/PIC-2012-017.

Abstract

Evaluate the usage of octreotide for the control of acute upper gastrointestinal bleeding in children with portal hypertension. A retrospective electronic database analysis of these children was performed over a period of five years. Setting was a tertiary pediatric intensive care. Case notes of 18 encounters in 13 children were reviewed. A loading dose (1.27 ± 0.76 µg/kg) was administered in seven, with median starting dose of 1.44 ± 1.19 µg/kg/h in all other episodes. The mean maximum dose was 1.68 ± 1.38 µg/kg/h. Re-bleeding occurred in one third; hemostasis was eventually achieved in all. Octreotide infusion appears to be safe and effective in controlling pediatric upper gastrointestinal bleeding due to portal hypertension. We also recommend its use in community and rural hospital settings prior to transfer of such patients to a tertiary care center.

摘要

评估奥曲肽在控制门静脉高压患儿急性上消化道出血中的应用。对这些患儿进行了为期五年的回顾性电子数据库分析。研究地点为三级儿科重症监护病房。回顾了13名患儿18次就诊的病历。7例给予负荷剂量(1.27±0.76µg/kg),其他所有病例的起始剂量中位数为1.44±1.19µg/kg/h。平均最大剂量为1.68±1.38µg/kg/h。三分之一的患儿再次出血;最终所有患儿均实现止血。奥曲肽输注在控制门静脉高压所致小儿上消化道出血方面似乎安全有效。我们还建议在将此类患者转诊至三级护理中心之前,在社区和农村医院环境中使用奥曲肽。

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