| Objective :Selct the patients who progess to the stage of cirrhosis, with esophageal variceal bleeding, give these patients different dosages of somatostatin or octreotide treated, to observe the hemostasis time, 24 h hemostatic rate, bleeding after maintaining treatment three days after discontinuation of the rate of rebleeding, observe the drug adverse effect during the Period of treatment and observe the three groups of patients with average hospitalization days, the different of blood transfusion.Methods:Selct 70 patients totally,include male 41 cases,female 29 cases,they were all diagnosed by anamnesis, ultrasonography and CT for clinical esophageal variceal bleeding patients, and these patients with much bleeding(more than 1000ml), divided them for three groups randomly: group A(26 cases, average age 47.65 ±15.13 years, average weight 58.23 ±8.52Kg): in this group given them basis of general treatment(proton pump inhibitor, hemostatic quick, expansion, etc.),besides that,gave them somatostatin with rate of 250 mg / h, continuous micro droplet pump injection. Group B(23 cases, average age 48.87 ±15.56, average weight48.87±15.56Kg): in this group given them basis of general treatment(proton pump inhibitor, hemostatic quick, expansion, etc.),besides that, gave them a double dose of somatostatin,with rate of 500ug/h, continuous micro droplet pump injection. C group(21 cases, the average age was 46.86± 14.39, weight 57.95± 6.54Kg): in the given(proton pump inhibitor, hemostatic quick, expansion, etc.) on the basis of general treatment given,besides that, gave them the octreotide with rate of 50ug/h, continuous micro droplet pump injection. Observed the three groups of patients with bleeding time, 24 h hemostatic rate, after stopping bleeding rate, adverse drug reaction incidence rate,average blood transfusion, average hospitalization days, compared those groups whether they have some statistical significance.Results:1.Those three groups were all selected by the age, weight, hemoglobin, blood coagulation time, total protein, albumin, alanine aminotransferase, creatinine, urea nitrogen for pairwise comparison,there were no much difference(if the P > 0.05), three groups of patients can be compared. 2 A(normal somatostatin) with group B(double somatostatin) group: comparison them in the hemostasis time, that is(21.80 ±7.01 vs 15.6± 5.47),,the P=0.01 < 0.05,we can conclude there was much difference with those two groups, the double somatostatin group’s patients bleeding time were shorter than ordinary somatostatin group;those two groups comparison in 24 h hemostatic rate,this is(42.3%vs 91.3%), by chi square test we know that χ2=12.93 > 5.97, P < 0.0166, it had huge difference with two groups, we can conclude the double somatostatin group is shorter than that of the ordinary somatostatin group in 24 h hemostatic rate; the two groups in the incidence of adverse reactions, i.e.(7.6%vs 4.35%), by chi square test we know that χ2=0.026 < 5.97, P > 0.0166, there was no huge difference between the two groups; 3 days after withdrawal of rebleeding, observed the two groups of patients, after drug withdrawal there were all no rebleeding patients; two groups in averge blood transfusion on the comparison,it is(594.23±301.77 vs 310.87 ±116.73),P=0.010<0.05,we know they have big difference in two groups; the two groups in the comparison of average hospitalization days, that is(20.53 ± 11.43 vs 14.00 ±1.84), P=0.042 < 0.05,they have huge difference among the two groups. 3.A(general somatostatin) and group C(octreotide) group comparison: comparison in the hemostasis time, that is(21.80±7.01 vs 15.38 ±6.19),,P=0.03 < 0.05, there was huge difference in two groups comparison; the two group in the 24 h on the hemostatic rate comparison, that is(42.3%vs 85.7%), by the chi square test χ2=9.26 > 5.97, P < 0.0166, we can conclude there have huge differences among them, common somatostatin is higher than the octreotide group in the 24 h on the hemostatic rate; the two groups in the incidence of adverse reactions, that is(7.6%vs 4.8%), by chi square test thatχ2=0.036 < 5.97, P > 0.0166, there was no huge difference among there comparison; 3 days after withdrawal of rebleeding, two groups of patients all have no one rebleeding patients after drug withdrawal; two groups in blood transfusion on the comparison, that is(594.23±301.77 vs 397.62 ±223.31),P=0.022<0.05,there was much difference among the two groups; the two groups in the average hospitalization days on comparison,that is(20.53±3.07vs14±1.84),,P=0.047 < 0.05, there was no huge difference among the two groups. 4.B(double somatostatin) group and C group(octreotide) in the hemostasis time, in the time of hemostasis,that is(15.6 ±5.47 vs 15.38 ± 6.19), P=0.8980 > 0.05,we can know there was no huge difference between the two groups; the two group in the 24 h on the hemostatic rate comparison, that is(91.3%vs 85.7%), by the chi square test we know that χ2=0.012 < 5.97, P > 0.0166, the two groups have no huge difference in the 24 h on the hemostatic rate comparison,so that, the hemostatic rate showed not much difference between the two groups; compared to the incidence of the adverse reactions, that is(4.35%vs 4.8%), by chi square test thatχ2=0.43 < 5.97, P > 0.0166, no huge difference with two groups; 3 days after withdrawal of rebleeding,compared the two groups of patients, after drug withdrawal there were all have no rebleeding patients; two groups in averge blood transfusion on the comparison, that is(310.87 ±116.73 vs 397.62 ±223.31),P=0.323>0.05, there were no obvious difference between the two groups; the two group in the average hospitalization days comparison, that is(11.43 ± 1.99 vs 14 ± 1.84), P=0.741 > 0.05, the two groups have no significant difference in the average hospitalization days.Conclusion: There were no obvious difference of the double dose of somatostatin with the octreotide group in bleeding time,but those two groups’ bleeding time were all shorter than the ordinary somatostatin group;the double dose of somatostatin group and the octreotide group in the hemostasis rate has no obvious difference, and the hemostasis rate are better than ordinary somatostatin group; the incidence rate of adverse in response, three groups showed not much difference; three groups of patients after drug withdrawal were no rebleeding patients; in average blood transfusion, compared with the double dose somatostatin group and the octreotide group we have no specific difference in blood transfusion but they both were less than the ordinary somatostatin group; comparison of the average hospitalization days, double the dose of somatostatin group and octreotide group had no obvious difference, but the average time were shorter than the ordinary somatostatin group. In conclusion, doubling the dose somatostatin group and the octreotide group in bleeding time, hemostatic rate, blood transfusion volume, average hospitalization day has no huge difference,but they are all better than the ordinary somatostatin group, preferred in clinic to use. The three groups drugs all can prevent the patient rebleeding if we continue use the drug after stopping bleeding three days. |
PDF Full Text Request