The Effect Of Sandostatin On Treating Massive Peptic Ulcer Bleeding

Peptic ulcer bleeding is the most familiar causation of uppergastrointestinal bleeding (UGB), account for about half of all thecause of UGB. Massive upper gastrointestinal bleeding advancequickly, is one of the most frequent acute danger severe cases, cancause hemorrhagic shock and lead to patient's death, consequently, tocontrol UGB quickly efficiently in earlier period is not only the key ofsalvageing successfully, butalso the problem which we should solveclinically at first. In the aspect of drug treatment peptic ulcer bleedingwas much treated with inhibiting the secretion of gastric acid,protecting the gastric mucous membrane, promoting thrombosis andhemostasis of bleeding part and so on. When the pathological changesarea that cause peptic ulcer bleeding is big, or the pathologicalchanges is deep, or erode the great vessels, bleeding is more fierce,sometimes the aforesaid hemostasis effect at this time is not satisfiedcompletely, and the time required to stop bleeding is prolonged, butthe effect of Sandostatin on treating upper gastrointestinal bleeding isconfirm-ed widespreadly in the last few years. Objective: Sandostatinis man-made composite somatostatin, canselectively contract visceral vessel, inhibit the secretion of gastric acidand protect the gastric mucous membrane etc. under nonsurgicaloperation and no hardening agent treatment circumstances, this textobserve the effect of common hemostasis plus sandostatin on treatingmassive peptic ulcer bleeding, and compare it with simple commonhemostasis treatment, so as to further know clinic significance ofSandostatin on treating massive peptic ulcer bleeding.Methods: 76 peptic ulcer bleeding patients who would receivetreatment in hospital between 2004 and 2006 were randomly dividedinto two groups A and B. All the patients in two groups received theusual cares of acute upper gastrointestinal bleeding, and were giveninternal medicine combined therapy: losec inhibits the secretion ofgastric acid, Reptilase and partis douche intragastrically(8%norepinephrineice liquor natrii chloridi isotonicus) for hemostasis,blood transfusion, infection prevention etc. Meanwhile sandostatinwas as an adjunct treatment in group A. Patients in group A receivedan intravenous injection of 0.1 mg of sandostatin followed bycontinuous intravenous drip of sandostatin at a constant speed of 25microg/h for 48 hours. It will be observered respectively stoppinghemorrhage rate at 6 hours, 12 hours, 24 hours, 48hours aftertreatment, in addition, rebleeding incidence rate within 72 hours andoccurring untoward effects. All the cases were diagnosed specificallypeptic ulcer bleeding via endoscope inspection, and their diagnosiswas consistent with massive upper gastrointestinal bleeding:hematemesis (and) or darkstools, blood losed>1000 ml or 20% ofvolume of circulation in short term. These patients presented thefollowing one or more features: low blood pressure <120/80mmHg,rapid pulse rate>120/min, low RBC<2.5×1012/L, low Hb<8g/dL etc.The following diseases or circumstances were excluded: ulcer withpyloric obstruction or perforation and other serious diseases, such asthe liver, kidney, heart and cerebrovascular diseases, nosohemia, anytumor patients, or having the history of drug hypersensitivity. statisticanalysis: experimental data were denoted by average ± standarddeviation( ±S), numeration data were denoted by percentage (%),variation among groups used Chi-square (χ2) test. P<0.05 showedthat variation was significant.Result: In two groups A and B, 6 hours hemostasis rate wererespectively 51.4%, 28.2%, 12 hours hemostasis rate were75.7%,53.8%, 24hours hemostasis rate were86.5%, 64.1%, 48hourshemostasis rate were97.3%, 79.5%. we compared respectively groupA with group B in hemostasis rate from 6 hours to 48 hours by usingChi-square (χ2) test. and every result was P<0.05, which showedstatistical variation.This indicated the hemostasis effect of groupsA(plus sandostatin) is much better than the latter (no sandostatin) in 6hours, 12 hours, 24 hours and 48 hours. Rebleeding rates had nostatistical variation (P>0.05). untoward effects: 2 patients hadsicchasia, emesia, abdominal (5.4%) in group A, 4 patients hadlanguor, myasthenia of limbs (10.3%) in groupB,which had nostatistical variation (P>0.05).Conclusion: The effect of sandostatin on treating massive pepticulcer bleeding is certain. The patients of peptic ulcer bleeding,especially danger severe massive hemorrhea should use conventionaltherapy plus sandostatin as soon as possible. In same timesandostatin-containing group has better effective than no sandostatingroup on treating massive peptic ulcer bleeding. under the samehemostasis rate conditions sandostatin-containing group need shorttertime to stop bleeding than no sandostatin group.