摘要
[目的]评价使用奥曲肽联合奥美拉唑治疗肝硬化合并上消化道出血的临床疗效。[方法]入选我院2016-03-2018-03期间收治的肝硬化合并上消化道出血患者97例,随机分为观察组(49例)和对照组(48例)。对照组给予垂体后叶素联合奥美拉唑治疗,观察组给予奥曲肽联合奥美拉唑治疗,疗程均为3 d。比较2组患者临床治疗效果、止血时间、输血量及48 h再出血情况,治疗前后血清一氧化氮(NO)、血清胰高血糖素水平变化及不良反应发生情况。[结果]观察组有效率为93.88%,明显高于对照组的70.83%(Z=-7.605,P<0.01)。观察组平均止血时间(16.03±4.78)h、输血量(1.38±0.31)U、再出血率8.16%,均明显低于对照组的(31.17±5.49)h、(2.79±0.54)U、27.08%(t=-14.474,P<0.01;t=-15.729,P<0.01;χ^2=6.005,P<0.05)。治疗后,2组血清NO、血清胰高血糖素水平与治疗前比较均显著降低(t=11.143,P<0.01;t=5.504,P<0.01;t=16.039,P<0.01;t=9.654,P<0.01);且观察组血清NO、血清胰高血糖素水平均显著低于对照组(t=-5.063,P<0.01;t=-6.693,P<0.01)。2组不良反应发生率比较差异无统计学意义(χ^2=0.384,P>0.05)。[结论]应用奥曲肽联合奥美拉唑治疗肝硬化合并上消化道出血患者,临床治疗效果显著,可有效缩短止血时间,减少输血量及再次出血率,安全性高,值得推广应用。
[Objective]This study aims to investigate the clinical effect of octreotide combined with omeprazole in the treatment of hepatic cirrhosis complicated with upper gastrointestinal bleeding.[Methods]The totals of 97 admitted patients with cirrhosis complicated with upper gastrointestinal hemorrhage admitted from March 2016 to March 2018 in our hospital in our hospital were randomly divided into observation group(OG,n=49)and control group(CG,n=48).The CG was treated with pituitrin combined with omeprazole,while the OG was treated with octreotide combined with omeprazole.The clinical efficacy,hemostasis time,blood transfusion volume and 48-hour rebleeding rate were compared between the two groups.The change of the levels of serum NO and glucagon before and after treatment and the occurrence of adverse reaction were also compared.[Results]The effective rate of the OG was 93.88%,which was significantly higher than that of 70.83%in the CG(Z=-7.605,P<0.01).The average hemostasis time was(16.03±4.78)h,the blood transfusion volume was(1.38±0.31)U,and the rebleeding rate was 8.16%,which was significantly lower than that in the CG([31.17±5.49]h,[2.79±0.54])U,27.08%)t=-14.474,P<0.01;t=-15.729,P<0.01;χ^2=6.005,P<0.05).After treatment,the levels of serum NO and glucagon in the two groups were significantly lower than those of before treatment(t=11.143,P<0.01;t=5.504,P<0.01;t=16.039,P<0.01;t=9.654,P<0.01);and the level of serum NO and glucagon in the OG were significantly lower than those of in the CG(t=-5.063,P<0.01;t=-6.693,P<0.01).There was no significant difference in the incidence of adverse reaction between the two groups(χ^2=0.384,P>0.05).[Conclusion]It has a significant clinical effect of octreotide combined with omeprazole in the treatment of liver cirrhosis patients complicated with upper gastrointestinal bleeding.It can effectively shorten the hemostasis time,reduce the amount of blood transfusion and bleeding rate.With the high safety,it is worthy of promotion and application.
作者
范春梅
FAN Chun-mei(Department of Gastroenterology,the Fifth People's Hospital of Qinghai Province,810007 Xining,Qinghai Province,China)
出处
《临床消化病杂志》
2019年第6期384-387,共4页
Chinese Journal of Clinical Gastroenterology
关键词
肝硬化
上消化道出血
奥曲肽
奥美拉唑
血清一氧化氮
血清胰高血糖素
再出血率
hepatic cirrhosis
upper gastrointestinal bleeding
octreotide
omeprazole
serum nitric oxide
serum glucaginin
rebleeding rate
