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目的观察垂体后叶素联合硝酸甘油治疗肝硬化食管胃底静脉曲张破裂出血(esophageal and gastric variceal bleeding,EGVB)的临床疗效及安全性。方法选择我科经胃镜下诊断的86例EGVB病例随机分为A、B、C组。A组(32例)以垂体后叶素10 u静注后,继以0.2 u/min加硝酸甘油10～30μg/min持续静滴;B组(28例)以善得定100μg静注后,继以25μg/h持续静滴;C组(26例)以垂体后叶素10 u静注后,继以0.2 u/min持续静滴。止血后剂量减半,持续用药2 d,通过胃管观察各组的止血效果。结果A、B组止血时间均短于C组(P<0.05,P<0.01),A、B组间差异无统计学意义(P>0.05);A、B和C组显效率分别为21.88%、28.57%和11.54%,总有效率分别为75.00%、82.14%和53.85%,B组总有效率高于C组(P<0.05),3组间显效率及A、B组间总有效率差异均无统计学意义(P>0.05)。C组不良反应较多,A、B组间不良反应差异无统计学意义(P>0.05)。结论垂体后叶素联合硝酸甘油治疗肝硬化EGVB有良好的疗效,不良反应较少。
Objective To observe the clinical efficacy and safety of pituitrin combined with nitroglycerin in the treatment of esophageal and gastric variceal bleeding (EGVB). Methods 86 cases of EGVB diagnosed by gastroscopy in our department were randomly divided into A, B and C groups. Group A (n = 32) received vasopressin 10 u intravenously followed by 0.2 u / min plus nitroglycerin 10 ~ 30 μg / min for intravenous infusion. In group B (n = 28) Followed by 25μg / h continuous intravenous infusion; C group (26 cases) pituitrin 10 u intravenous, followed by 0.2 u / min continuous intravenous infusion. The dosage was halved after the hemostasis, and the medication was continued for 2 days. The hemostatic effect of each group was observed by gastric tube. Results The bleeding time in group A and group B was shorter than that in group C (P <0.05, P <0.01), but there was no significant difference between group A and group B (P> 0.05). The effective rates of group A, B and C were 21.88% , 28.57% and 11.54%, respectively. The total effective rates were 75.00%, 82.14% and 53.85% respectively. The total effective rate in group B was higher than that in group C (P <0.05) There was no significant difference (P> 0.05). Adverse reactions were more in group C, but there was no significant difference in side effects between groups A and B (P> 0.05). Conclusions Pituitrin combined with nitroglycerin has a good curative effect on EGCB with less side effects.