간경변 환자의 정맥류 출혈에서 Octreotide의 지혈효과 = Clinical Analysis of Octreotide in Varix Bleeding

다국어 초록 (Multilingual Abstract)

Purpose: This study was conducted to confirm the effects of octreotide in patients with variceal bleeding.
Methods: We performed a retrospective analysis of 26 patients with variceal bleeding, who visited the Emergency Center of Seoul National University Hospital from January 1st to June 31st,1996, the control group, and a prospective analysis of 28 patients with variceal bleeding, who visited the Emergency Center of Seoul National University Hospital from March 1st to August 31st, 1999, for the octreotide-infused group. The octreotide-infused group recieved a continuous infusion of octreotide, 25㎍/hr, for 5 days after an initial bolus of 50 ㎍. When active bleeding continued over 1 hour, over 5 pints of packed-RBC were needed for transfusion within 24 hours, or when the systolic blood pressure was under 90mmHg, a ballon tamponade with Sengstaken-Blackemore tube was used. T-test and X2 test were used for statistic at analysis (p<0.05).
Results: Forty-one patients were male(octreotide-infused group 22, control group 19) and 13 were female(octreotide-infused group 6, control group 7). The mean age was 55 years(octreotide-infused group 56 years, control group 52 years). There were no significant differences in vital signs, hemoglobin/hematocrit levels, and Child-Pugh's classifications between the octreotide-infused group and the control group initially. There was a significant difference in the rates of early bleeding control within 24 hours(p<0.05), but there were no significant differences in the rates of rebleeding, mortality within 1 week, and use of a balloon tamponade.
Conclusion: Variceal bleeding is a serious complication of liver cirrhosis and has a high mortality rate. Octreotide is an effective vasoactive agent for control of early bleeding, Thus, octreotide should be used first before endoscopic definitive therapies, to stabilize the vital signs of patients and to secure a field for endoscopic procedures.

목차 (Table of Contents)

• I.서론
• II.대상과 방법
• III.결과
• 1.성별 및 연령별 분포
• 2.내원당시 진찰 소견 및 검사 소견
• 3.24시간내 초기 지혈여부
• 4.초기 지혈된 증례에서의 1주내 재출혈
• 5.1주내 사망여부
• 6.풍선압박술의 사용여부
• IV.고찰
• V.결론