摘要
目的研究醋酸奥曲肽联合奥美拉唑治疗肝硬化门静脉高压所致上消化道出血的临床效果及对血流的影响。方法选取2012年12月至2015年12月本院收治的因肝硬化门静脉高压所致上消化道出血的96例患者为研究对象,将其随机分为联合组及对照组,每组各48例。联合组患者采用醋酸奥曲肽联合奥美拉唑治疗,对照组患者采用奥美拉唑治疗,两组患者均治疗7天。检测两组患者治疗前后胰高血糖素、血清一氧化氮(NO)、门静脉血流量及脾静脉血流量,比较两组患者平均止血时间及48小时再出血率。结果首次给药2小时后,联合组患者胰高血糖素及血清NO水平明显低于对照组(P<0.01);治疗结束后,联合组患者门静脉血流量及脾静脉血流量均明显少于对照组(P<0.01),平均止血时间明显短于对照组(P<0.01),48小时后再出血率明显低于对照组(P<0.01),治疗总有效率高于对照组(P<0.05)。结论醋酸奥曲肽联合奥美拉唑治疗肝硬化门静脉高压所致上消化道出血,止血时间较短,有效保护患者胃黏膜,降低门静脉压力,改善侧支循环及胃底静脉曲张,防止再次出血。
Objective To explore the effects on hemodynamics and hemostasia effect of octreotide acetate combined with omeprazole in the treatment of upper gastrointestinal bleeding caused by cirrhosis. Method 96 cases of upper gastrointestinal bleeding caused by cirrhosis in our hospital from December 2012 to December 2015 were randomly divided into combination group and control group, 48 cases in each group. Patients in combination group were treated with octreotide acetate combined with omeprazole, patients in control group were treated with omeprazole, patients in the two groups were treated for 7 days. The levels of glucagon, serum NO, portal venous flow and spleen venous flow, average hemostasis time, 48 hours recurrent bleeding rate before and after treatment were compared between the two groups. Result The level of glucagon and serum NO in combination group were obviously lower than those in control group at 2 hours after first dose（P〈0.01）; the portal venous flow and spleen venous flow in combination group were markedly less than those in control group at the end of the treatment（P〈0.01）; average hemostasis time and 48 hours recurrent bleeding rate of combination group were less than control group（P〈0.01）, the total effective rate of combination group was higher than control group（P〈0.05）. Conclusion Octreotide acetate combined with omeprazole in the treatment of upper gastrointestinal bleeding caused by cirrhosis has shorter bleeding time, protect gastric mucosa, reduce portal vein pressure, improve collateral circulation and prevent recurrent bleeding.
出处
《中国医学前沿杂志（电子版）》
2016年第9期133-136,共4页
Chinese Journal of the Frontiers of Medical Science(Electronic Version)
关键词
肝硬化
上消化道出血
醋酸奥曲肽
奥美拉唑
Cirrhosis
Upper gastrointestinal bleeding
Octreotide acetate
Omeprazole
