Terlipressin Combined with Somatostatin in Treatment of Hemorrhage of Esophagogastric Varices Due to Portal Hypertension in Liver Cirrhosis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 張磊 , 章銳 , 劉飛龍 ,  張萬廣

華中科技大學同濟醫學院附屬同濟醫院肝臟外科中心（湖北武漢 430030）;

Corresponding?author：

張萬廣, Email: wgzhuang@medmail.com.cn

Keywords：

特利加壓素; 生長抑素; 門靜脈高壓癥; 食管胃底靜脈曲張; 出血

DOI：

10.7507/1007-9424.20140341

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

目的觀察特利加壓素聯合生長抑素治療肝硬變門靜脈高壓食管胃底曲張靜脈破裂出血的效果。方法我院2008年3月至2012年8月期間收治的47例肝硬變門靜脈高壓食管胃底曲張靜脈破裂出血患者入院時采用擲硬幣法被隨機分為特利加壓素＋生長抑素組（n=24）和生長抑素組（n=23），分別給予聯合用藥或單獨使用生長抑素，計算24 h止血率、總止血率、1周再出血率、1周死亡率，觀察不良反應發生、尿量及腹水量情況。結果特利加壓素＋生長抑素組24 h止血率、總止血率和不良反應發生率明顯高于生長抑素組（P＜0.05），1周再出血率明顯低于生長抑素組（P＜0.05），2組1周死亡率比較差異無統計學意義（P＞0.05），特利加壓素＋生長抑素組尿量明顯多于生長抑素組（P＜0.05），盆腔腹水量明顯少于生長抑素組（P＜0.05）。結論特利加壓素聯合生長抑素用于肝硬變門靜脈高壓食管胃底曲張靜脈破裂出血止血效果確切，可以明顯降低死亡率；雖然其不良反應發生率略高，但均可以控制。

Citation： 張磊, 章銳, 劉飛龍, 張萬廣. Terlipressin Combined with Somatostatin in Treatment of Hemorrhage of Esophagogastric Varices Due to Portal Hypertension in Liver Cirrhosis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(11): 1436-1438. doi: 10.7507/1007-9424.20140341 Copy

1.	?陳孝平.門靜脈高壓癥外科治療現狀[J].腹部外科, 2007, 20(2):70-71.
2.	陳孝平, 陳義發.我國門靜脈高壓癥外科治療進展[J].國際外科學雜志, 2008, 35(7):435-436.
3.	Gotoh Y, Iwakiri R, Sakata Y, et al.Evaluation of endoscopic variceal ligation in prophylactic therapy for bleeding of oesophageal varices:a prospective, controlled trial compared with endoscopic injection sclerotherapy[J].J Gastroenterol Hepatol, 1999, 14(3):241-244.
4.	Lo GH, Lai KH, Cheng JS, et al.A prospective, randomized trial of butyl cyanoacrylate injection versus band ligation in the management of bleeding gastric varices[J].Hepatology, 2001, 33(5):1060-1064.
5.	Sarin SK, Jain AK, Jain M, et al.A randomized controlled trial of cyanoacrylate versus alcohol injection in patients with isolated fundic varices[J].Am J Gastroenterol, 2002, 97(4):1010-1015.
6.	陳孝平, 汪建平.外科學[M].第8版.北京:人民衛生出版社, 2013:437-443.
7.	Sarin SK, Sharma P.Terlipressin:an asset for hepatologists![J].Hepatology, 2011, 54(2):724-728.
8.	Wang YK, Hwang DY, Wang SS, et al.Terlipressin-induced hyponatremic encephalopathy in a noncirrhotic patient[J].Kaohsiung J Med Sci, 2013, 29(12):691-694.
9.	王維民, 王歆光.藥物在防治門靜脈高壓癥上消化道出血中的作用[J].中華外科雜志, 2007, 45(13):865-867.
10.	任祖海, 葉啟發, 余偉平, 等.terlipressin對肝大部切除術后早期小體積肝功能保護機制的研究[J].中國普通外科雜志, 2010, 19(7):756-762.
11.	郭蓮怡, 王桂君.生長抑素聯合特利加壓素治療肝硬化急性食管靜脈曲張破裂出血患者的臨床觀察[J].中國藥房, 2012, 23(32):2998-3000.
12.	Krag A, Borup T, M?ller S, et al.Efficacy and safety of terlipressin in cirrhotic patients with variceal bleeding or hepatorenal syndrome[J].Adv Ther, 2008, 25(11):1105-1140.
13.	Ginès P, Guevara M.Therapy with vasoconstrictor drugs in cirrhosis:The time has arrived[J].Hepatology, 2007, 46(6):1685-1687.
14.	Rodríguez E, Elia C, Solà E, et al.Terlipressin and albumin for type-1 hepatorenal syndrome associated with sepsis[J].J Hepatol, 2014, 60(5):955-961.
15.	張志偉, 陳孝平.思他寧治療肝硬化門靜脈高壓食管胃底曲張靜脈破裂大出血的臨床療效觀察[J].臨床外科雜志, 2003, 11(5):311-312.
16.	Villanueva C, Ortiz J, Sàbat M, et al.Somatostatin alone or combined with emergency sclerotherapy in the treatment of acute esophageal variceal bleeding:a prospective randomized trial[J].Hepatology, 1999, 30(2):384-389.
17.	McCormick PA, Biagini MR, Dick R, et al.Octreotide inhibits the meal-induced increases in the portal venous pressure of cirrhotic patients with portal hypertension:a double-blind, placebo-controlled study[J].Hepatology, 1992, 16(5):1180-1186.
18.	Sundriyal D, Kumar N, Patnaik I, et al.Terlipressin induced ischaemia of skin[J].BMJ Case Rep, 2013, 2013.Pii:bcr2013010050.doi:10.1136/bcr-2013-010050.
19.	Kim HR, Lee YS, Yim HJ, et al.Severe ischemic bowel necrosis caused by terlipressin during treatment of hepatorenal syndrome[J].Clin Mol Hepatol, 2013, 19(4):417-420.

1. ?陳孝平.門靜脈高壓癥外科治療現狀[J].腹部外科, 2007, 20(2):70-71.
2. 陳孝平, 陳義發.我國門靜脈高壓癥外科治療進展[J].國際外科學雜志, 2008, 35(7):435-436.
3. Gotoh Y, Iwakiri R, Sakata Y, et al.Evaluation of endoscopic variceal ligation in prophylactic therapy for bleeding of oesophageal varices:a prospective, controlled trial compared with endoscopic injection sclerotherapy[J].J Gastroenterol Hepatol, 1999, 14(3):241-244.
4. Lo GH, Lai KH, Cheng JS, et al.A prospective, randomized trial of butyl cyanoacrylate injection versus band ligation in the management of bleeding gastric varices[J].Hepatology, 2001, 33(5):1060-1064.
5. Sarin SK, Jain AK, Jain M, et al.A randomized controlled trial of cyanoacrylate versus alcohol injection in patients with isolated fundic varices[J].Am J Gastroenterol, 2002, 97(4):1010-1015.
6. 陳孝平, 汪建平.外科學[M].第8版.北京:人民衛生出版社, 2013:437-443.
7. Sarin SK, Sharma P.Terlipressin:an asset for hepatologists![J].Hepatology, 2011, 54(2):724-728.
8. Wang YK, Hwang DY, Wang SS, et al.Terlipressin-induced hyponatremic encephalopathy in a noncirrhotic patient[J].Kaohsiung J Med Sci, 2013, 29(12):691-694.
9. 王維民, 王歆光.藥物在防治門靜脈高壓癥上消化道出血中的作用[J].中華外科雜志, 2007, 45(13):865-867.
10. 任祖海, 葉啟發, 余偉平, 等.terlipressin對肝大部切除術后早期小體積肝功能保護機制的研究[J].中國普通外科雜志, 2010, 19(7):756-762.
11. 郭蓮怡, 王桂君.生長抑素聯合特利加壓素治療肝硬化急性食管靜脈曲張破裂出血患者的臨床觀察[J].中國藥房, 2012, 23(32):2998-3000.
12. Krag A, Borup T, M?ller S, et al.Efficacy and safety of terlipressin in cirrhotic patients with variceal bleeding or hepatorenal syndrome[J].Adv Ther, 2008, 25(11):1105-1140.
13. Ginès P, Guevara M.Therapy with vasoconstrictor drugs in cirrhosis:The time has arrived[J].Hepatology, 2007, 46(6):1685-1687.
14. Rodríguez E, Elia C, Solà E, et al.Terlipressin and albumin for type-1 hepatorenal syndrome associated with sepsis[J].J Hepatol, 2014, 60(5):955-961.
15. 張志偉, 陳孝平.思他寧治療肝硬化門靜脈高壓食管胃底曲張靜脈破裂大出血的臨床療效觀察[J].臨床外科雜志, 2003, 11(5):311-312.
16. Villanueva C, Ortiz J, Sàbat M, et al.Somatostatin alone or combined with emergency sclerotherapy in the treatment of acute esophageal variceal bleeding:a prospective randomized trial[J].Hepatology, 1999, 30(2):384-389.
17. McCormick PA, Biagini MR, Dick R, et al.Octreotide inhibits the meal-induced increases in the portal venous pressure of cirrhotic patients with portal hypertension:a double-blind, placebo-controlled study[J].Hepatology, 1992, 16(5):1180-1186.
18. Sundriyal D, Kumar N, Patnaik I, et al.Terlipressin induced ischaemia of skin[J].BMJ Case Rep, 2013, 2013.Pii:bcr2013010050.doi:10.1136/bcr-2013-010050.
19. Kim HR, Lee YS, Yim HJ, et al.Severe ischemic bowel necrosis caused by terlipressin during treatment of hepatorenal syndrome[J].Clin Mol Hepatol, 2013, 19(4):417-420.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Terlipressin Combined with Somatostatin in Treatment of Hemorrhage of Esophagogastric Varices Due to Portal Hypertension in Liver Cirrhosis

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content