普萘洛尔、奥曲肽对肝硬化上消化道出血患者血流动力学的影响及其止血效果

The influence of propranolol and octreotide on hemodynamic of cirrhosis patients with upper gastrointestinal bleeding and its hemostatic effect

目的探讨普萘洛尔、奥曲肽对肝硬化上消化道出血患者血流动力学的影响及其止血效果。方法选择本院2011年6月～2012年3月收治的肝硬化上消化道出血患者60例,随机分为研究组和对照组,各30例,其中对照组患者单纯给予奥曲肽治疗,研究组患者在对照组的基础上给予普萘洛尔治疗,治疗1～3d后观察两组止血效果,采用彩色多普勒超声显像,观察患者治疗前后脾静脉及门静脉血流情况。结果研究组止血时间明显短于对照组(P<0.05),研究组患者治疗总有效率明显高于对照组(P<0.05);两组治疗后门静脉、脾静脉血流量均较治疗前明显减少(P<0.05),但研究组血流量明显低于对照组(P<0.05)。结论奥曲肽和普萘洛尔联合治疗肝硬化上消化道出血,止血时间短,有效率高,可有效降低门脉血流量,有较高的实用性。

Objective To investigate the influence of propranolol and octreotide on hemodynamic of cirrhosis patients with upper gastrointestinal bleeding and its hemostatic effect. Methods Sixty cases of upper gastrointestinal bleeding patients with cirrhosis admitted to our hospital in June 2011 to March 2012 were randomly divided into study group and control group, all 30 cases in each group, the control group were simply given octreotide treatment, the study group were given propranolol treatment on the basis of the control group, after 1 to 3 days treatment hemostatic effect were observed, the color Doppler ultrasound imaging was used to observe the splenic vein and portal vein blood flow before and after treatment. Results The hemostasis time of study group was significantly shorter than that of the control group （P 0.05）, the total efficiency of study group was significantly higher （P 0.05）; two groups of treatment of portal vein, splenic vein flow than before treatment was significantly decreased （P 0.05）, but blood flow of the study group was significantly lower than the control group （P 0.05）. Conclusion The combined treatment of octreotide and propranolol use in gastrointestinal bleeding, bleeding stop time is short, it can effectively reduce the portal blood flow, it has a higher practicality.