CEREBELLAR SYNDROME IN MYXŒDEMA
CEREBELLAR SYNDROME IN MYXŒDEMA
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MYXŒDEMA 中的小脑综合征
DOI：
10.1016/s0140-6736(60)91424-0
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发表时间：
1960
期刊：
影响因子：
--
通讯作者：
R. Kelly
中科院分区：
文献类型：
--
作者：
E. Jellinek;R. Kelly
该组抗利尿激素控制晚期出血的最终失败反映了肝衰竭的程度，而不是治疗方法。抗利尿激素的价值在于其使用简单，并且作为食道填塞的替代方法有许多优点。短时间的作用显然不能令人满意，10分钟内静脉注射20单位的副作用即使是短暂的，也是令人不快的。然而，这个剂量是必要的，以达到充分降低门静脉压力，并且鉴于在每隔4小时重复给药后没有缺血性改变，这个剂量的使用似乎是安全的。8例肝硬化患者10分钟内静脉给予20单位血管加压素，可控制食管静脉曲张出血。估计门静脉压力下降。其中3例出血未复发，2例术后行门静脉吻合术。5例患者出血复发，抗利尿激素治疗效果下降。4名患者死于晚期大出血。高死亡率反映的是肝功能衰竭的程度，而不是治疗方法。血管加压素未见不良副作用，建议将其作为Sengstaken食管加压管的替代品。
ultimate failure of vasopressin to control terminal haemorrhage in this group reflects the degree of liver failure rather than the method of treatment. The value of vasopressin lies in its simplicity of use, and as an alterna-tive to oesophageal tamponade it has many advantages. The short duration of action is obviously unsatisfactory and the side-effects from a dosage of 20 units intravenously over ten minutes are unpleasant even if short-lived. However, this dosage is necessary to achieve an adequate reduction in portal pressure, and in view of the absence of ischaemic changes following repeated administration at four-hourly intervals, its use at this level would appear to be safe. Summary20 units of vasopressin given intravenously in ten minutes controlled haemorrhage from oesophageal varices in 8 patients with hepatic cirrhosis. Estimated portal pressures fell. In 3 patients bleeding did not recur, and in 2 of these portacaval anastomosis was later performed. Hemorrhage recurred in 5 patients and a diminished response to vasopressin was observed. 4 patients died with a terminal massive bleed. The high mortality reflected the degree of liver failure rather than the method of treatment. No adverse side-effects were observed with vaso-pressin and its use as an alternative to the Sengstaken cesophageal compression tube is suggested.