Nisan 2013
Özofagus varis kanamali hastalarda etiyolojik sebepler ve tedavi protokollerinin karsilastirilmasi
Comparison of the treatment protocols and etiologic factors in patients with esophageal varicealbleeding
- Ana Sayfa
- Sayılar
- Nisan 2013
- Özofagus varis kanamali hastalarda etiyolojik sebepler ve tedavi protokollerinin karsilastirilmasi...
Özet
Giris ve Amaç:Portal hipertansiyonun bir komplikasyonu olan özofagus varis kanamasinin medikal tedavisinde çesitli ilaçlar kullanilmistir. Somatostatin ve terlipressin günümüzde varis kanamasinin medikal tedavisinde yaygin olarak kullanilan ilaçlardir. Bu çalismanin amaci, portal hipertansiyona bagli özofagus varis kanamalarinin etiyolojilerini ve tedavide kullanilan somatostatinin ve terlipressinin etkinligini ve güvenirligini karsilastirmaktir. Gereç ve Yöntem: Prospektif olarak takip edilen 50 hastanin verileri geriye dönük degerlendirildi. Kanama ile basvuran 25 hastaya endoskopik bant tedavisi sonrasi somatostatin ve diger 25 hastaya terlipresin tedavisi verildi. Her iki grubun; hastanede yatis süreleri, tekrar kanama oranlari, kan transfüzyonu ve mortalite oranlari karsilastirildi.Bulgular:Bu çalismadaki etiyolojik nedenlerde ilk üç sirada hepatit B enfeksiyonu, alkol ve idiyopatik karaciger sirozu saptandi. Tedavide somatostatin ve terlipressin arasinda anlamli fark bulunmazken, tedavi oranlari somatostatinde %56, terlipressinde %60 olarak bulundu. Ayrica terlipressinin Child A-B’ye giren hastalarda etkinligi somatostatine göre daha yüksek, Child C hastalarda daha düsük saptanmistir. Sonuç:Somatostatin ve terlipressin özofagus varis kanamasinda birincil tedavide oldukça etkindirler ve güvenli bir sekilde uygulanabilirler.
Abstract
Background and Aims:Various drugs are used in the medical treatment of esophageal variceal bleeding, which is an important complication of portal hypertension. Today, somatostatin and terlipressin are widely used in the medical treatment of variceal bleeding. The purpose of this study was to evaluate the etiology of esophageal variceal bleeding due to portal hypertension and to compare the efficacy and reliability of somatostatin and terlipressin in the treatment. Materials and Methods:The data of 50 patients, followed prospectively, were evaluated retrospectively. Somatostatin was given to 25 of these patients as treatment following endoscopic band ligation. The other 25 patients were treated with terlipressin. The length of hospital stay, recurrence of bleeding, blood transfusion, and mortality rates were compared between the two groups. Results:Hepatitis B, alcohol, and idiopathic liver cirrhosis were the three primary etiological factors in this study. There were no significant differences in the efficacy of treatment between somatostatin and terlipressin, with cure rates of 56% and 60%, respectively. Terlipressin was more effective than somatostatin in Child A – B patients, but less effective in Child C patients. Conclusions:Somatostatin and terlipressin are quite effective in the primary treatment of esophageal variceal bleeding and can be implemented safely.
