Kaufman S L, Harrington D P, Barth K H, Maddrey W C, White R I
AJR Am J Roentgenol. 1977 Apr;128(4):567-9. doi: 10.2214/ajr.128.4.567.
Liver function and clotting tests were evaluated in 39 patients with variceal bleeding prior to superior mesenteric artery vasopressin infusion. In six patients with mild hepatic dysfunction (Child's class A), permanent control of hemorrhage was achieved in all six and all survived the hospitalization. In 21 patients with moderate dysfunction (Child's class B), permanent control of hemorrhage was achieved in 13 (62%) and temporary control for 24 hr or longer in the remaining eight (38%). Survival in class B was 67% (14 of 21). In only four of 12 patients with severe hepatic dysfunction (Child's class C) was control of hemorrhage achieved (33 percent). None of these patients survived. Therapeutic failure also was associated with clotting derangements and the initial bleeding rate. It is concluded that the effectiveness of vasopressin in variceal hemorrhage is a function of the underlying liver disease and derangements in clotting function.
在39例静脉曲张出血患者中，于肠系膜上动脉输注血管加压素之前对其肝功能和凝血功能进行了评估。6例轻度肝功能不全（Child分级A类）患者均实现了出血的永久性控制，且全部存活至出院。21例中度肝功能不全（Child分级B类）患者中，13例（62%）实现了出血的永久性控制，其余8例（38%）实现了24小时或更长时间的临时性出血控制。B类患者的存活率为67%（21例中的14例）。12例重度肝功能不全（Child分级C类）患者中仅有4例（33%）实现了出血控制。这些患者均未存活。治疗失败还与凝血紊乱及初始出血率相关。得出的结论是，血管加压素在静脉曲张出血中的有效性是潜在肝脏疾病及凝血功能紊乱的函数。
