Comparison of Somatostatin and Vasopressin in the Control of Acute Esophageal Variceal Hemorrhage-A Randomized Controlled Study

比較體抑素與血管升壓素對控制急性食道靜脈曲張出血之隨機對照研究

夏效中(Hsiao-Chung Hsia) ； 李發耀(Fa-Yauh Lee) ； 蔡養德(Yang-Te Tsai) ； 李壽東(Shou-Dong Lee) ； 黎國洪(Kwok-Hung Lai) ； 林文傑(Wen-Jeh Lin) ； 林漢傑(Han-Chieh Lin) ； 賴啟賢(Chii-Shyan Lay) ； 王聖賢(Sun-Sang Wang) ； 羅光瑞(Kwang-Juei Lo)

《中華民國消化系醫學會雜誌》 7卷2期 (1990/06) Pp. 71-78

https://doi.org/10.6557/GJTa.199006_7(2).0001

摘要

The present randomized controlled trial compared the effect of intravenous somatostatin and vasopressin in 46 cirrhotic patients with bleeding esophageal varices. Two groups of patients were well-matched for all parameters before randomization. Both drugs were given as continuous intravenous infusion for 24 hr (somatostatin, 250μg/hr after a bolus of 250μg; vasopressin, 0.4 units/mm). Bleeding was initially controlled after 6 hours of drug infusion in 95% (21/22) and 67% (16/24) of the patients treated with somatostatin and vasopressin respectively (p=0.016). Complete control of bleeding during 24hr of drug infusion was achieved in 12 (55%) patients receiving somatostatin and in 9 (38%) patients treated with vasopressin. Associated side effects were significantly lower in the somatostatin group (4/22) than in the vasopressin group (11/24), but death related to bleeding esophageal varices was similar in these two groups. This study showed that somatostatin is more effective and has fewer side effects than vasopressin in the initial control of acute esophageal variceal bleeding.

關鍵字

體抑素 ； 血管升壓素 ； 食道靜脈曲張出血

並列摘要

The present randomized controlled trial compared the effect of intravenous somatostatin and vasopressin in 46 cirrhotic patients with bleeding esophageal varices. Two groups of patients were well-matched for all parameters before randomization. Both drugs were given as continuous intravenous infusion for 24 hr (somatostatin, 250μg/hr after a bolus of 250μg; vasopressin, 0.4 units/mm). Bleeding was initially controlled after 6 hours of drug infusion in 95% (21/22) and 67% (16/24) of the patients treated with somatostatin and vasopressin respectively (p=0.016). Complete control of bleeding during 24hr of drug infusion was achieved in 12 (55%) patients receiving somatostatin and in 9 (38%) patients treated with vasopressin. Associated side effects were significantly lower in the somatostatin group (4/22) than in the vasopressin group (11/24), but death related to bleeding esophageal varices was similar in these two groups. This study showed that somatostatin is more effective and has fewer side effects than vasopressin in the initial control of acute esophageal variceal bleeding.

並列關鍵字

somatostatin ； vasopressin ； variceal bleeding