Sung J J, Chung S C, Lai C W, Chan F K, Leung J W, Yung M Y, Kassianides C, Li A K
Department of Medicine, Prince of Wales Hospital, Chinese University of Hong Kong.
Lancet. 1993 Sep 11;342(8872):637-41. doi: 10.1016/0140-6736(93)91758-e.
To compare octreotide with injection sclerotherapy in the treatment of acute variceal haemorrhage, patients admitted with gastrointestinal bleeding and oesophageal varices confirmed by endoscopy were randomised to receive either emergency sclerotherapy with 3% sodium tetradecyl sulphate or octreotide (50 micrograms intravenous bolus plus 50 micrograms per h intravenous infusion for 48 h). At the end of the study period (48 h), the octreotide group also had sclerotherapy to obliterate the varices. 100 patients were recruited. Demographic features including the aetiology of portal hypertension and the Child-Pugh's grading of the two groups were similar. Bleeding was initially controlled in 90% of patients by emergency sclerotherapy and in 84% by octreotide infusion (95% confidence interval 0-19.5, p = 0.55). There were no significant differences between the two groups in early (within 48 h of randomisation) rebleeding (16% vs 14%), blood transfusion (3 units vs 3.5), hospital stay (5 days vs 6 days), or hospital mortality (27% vs 20%). No notable side-effects were associated with octreotide. We conclude that octreotide infusion and emergency sclerotherapy are equally effective in controlling variceal haemorrhage.
为比较奥曲肽与注射硬化疗法治疗急性静脉曲张出血的效果，将因胃肠道出血入院且经内镜检查确诊为食管静脉曲张的患者随机分组，分别接受用3%十四烷基硫酸钠进行的紧急硬化疗法或奥曲肽治疗（静脉推注50微克，随后每小时静脉输注50微克，持续48小时）。在研究期结束时（48小时），奥曲肽组也接受硬化疗法以消除静脉曲张。共招募了100名患者。两组的人口统计学特征，包括门静脉高压的病因和Child-Pugh分级相似。紧急硬化疗法使90%的患者出血得到初步控制，奥曲肽输注使84%的患者出血得到初步控制（95%置信区间0 - 19.5，p = 0.55）。两组在早期（随机分组后48小时内）再出血（16%对14%）、输血（3单位对3.5单位）、住院时间（5天对6天）或医院死亡率（27%对20%）方面无显著差异。奥曲肽未出现明显副作用。我们得出结论，奥曲肽输注和紧急硬化疗法在控制静脉曲张出血方面同样有效。
