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- 저자 : 권순욱(Soon Wook Kweon) (검색결과 1 건)
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간경변증 환자에서 급성 정맥류 출혈에 대한 치료로서 somatostatin 과 vasopressin 의 효과에 대한 무작위 전향적인 비교연구
이헌영(Heon Young Lee),이헌주(Heon Ju Lee),이승민(Seung Min Lee),김준환(Jun Hwan Kim),권순욱(Soon Wook Kweon),이병석(Byung Seok Lee),김남재(Nam Jae Kim) 대한내과학회 2002 대한내과학회지 Vol.62 No.5
Background: Acute variceal bleeding is one of serious complications of liver cirrhosis that has an attendant mortality of approximately 60% during two years and a variety of treatments like balloon tamponade, sclerotherapy and vasoactive drugs have been used. The aim of the present trial was to compare the effectiveness and complications of somatostatin and vasopressin in the treatment of acute variceal bleeding. Methods: Fourty-three cirrhotic patients with endoscopically proven acute variceal bleeding were included. Both drugs were given as continuous intravenous infusions for 48 hour. Twenty patients received somatostatin (250 mcg per hour after a bolus of 50 mcg) and twenty-three recieved vasopressin (0.4 units per min). Results: There was no significant difference between two groups in relation to age, sex and etiology of cirrhosis, Child-Pugh classification, characteristics of bleeding episode, laboratory findings before randomization and units of transfused blood during therapy. Rebleeding within 6 hour after beginning of therapy, that is failure of initial control of bleeding, was observed in 3 (13.0%)patients receiving vasopressin and in 1 (5.0%) of those treated with somatostatin (p>0.05). Five patients (25.0%) in the somatostatin group and 5 (21.7%) in the vasopressin group rebled during 5 days after initial therapy (p>0.05). The meaningful complications related with vasopressin were observed in 5 patients (chest pain or abdominal pain requiring nitroglycerin) but serious complications of somatostatin were not found. Mortalities during hospitalization were similar in both treatment groups. Two of the vasopressin group and one of the somatostatin group died because of the uncontrolled rebleeding and one of the vasopressin group died due to hepatic failure. Conclusion : This study shows that the effectiveness of somatostatin and vasopressin was not different but somatostatin had a lower risk of the complication than vasopressin.(Korean J Med 62:497-503, 2002)
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