Tuggle D W, Bennett K G, Scott J, Tunell W P
Department of Surgery, University of Oklahoma College of Medicine, Oklahoma City.
J Pediatr Surg. 1988 Jul;23(7):627-9. doi: 10.1016/s0022-3468(88)80631-6.
Intravenous (IV) vasopressin has been used to control human upper gastrointestinal (GI) hemorrhage for over 30 years. Although the use of vasopressin has been studied extensively in adults, no study has evaluated its use in children. Vasopressin was used therapeutically in 15 episodes of esophageal variceal hemorrhage and two episodes of bleeding peptic ulcer. Nine of 17 episodes were controlled with vasopressin alone (53%). Balloon tamponade and variceal sclerosis were required for control in the remainder. Blood requirements averaged 53 mL/kg prior to control of hemorrhage. Metabolic complications occurred in 65% of the episodes. There were two groups of patients identified: those receiving greater or those receiving less than .01 units/kg/min of IV vasopressin. All of the complications identified occurred when greater than .01 U/kg/min of vasopressin were used (P less than .05). Control of bleeding was not improved with higher doses of vasopressin. These data suggest that the use of IV vasopressin at doses greater than .01 U/kg/min to control GI bleeding will increase the incidence of complications without improving control of hemorrhage.
静脉注射血管加压素已被用于控制人类上消化道出血超过30年。尽管血管加压素在成人中的应用已得到广泛研究，但尚无研究评估其在儿童中的应用情况。血管加压素被用于治疗15例食管静脉曲张出血和2例消化性溃疡出血。17例中有9例单用血管加压素得以控制（53%）。其余病例则需要气囊压迫和曲张静脉硬化术来控制出血。在出血得到控制之前，平均需血量为53 mL/kg。65%的病例出现了代谢并发症。确定了两组患者：接受静脉注射血管加压素剂量大于或小于0.01单位/千克/分钟的患者。所有已确定的并发症均发生在使用血管加压素剂量大于0.01 U/kg/min时（P小于0.05）。更高剂量的血管加压素并未改善出血控制情况。这些数据表明，使用剂量大于0.01 U/kg/min的静脉注射血管加压素控制胃肠道出血会增加并发症的发生率，而不会改善出血控制情况。
