奥美拉唑、奥曲肽和凝血酶联合治疗肝硬化并发食管胃底静脉曲张破裂出血患者的临床疗效

Clinical Efficacy of Omeprazole,Octreotide and Thrombin in the Treatment of Liver Cirrhosis Complicated with Esophageal and Gastric Variceal Bleeding

【目的】探讨奥美拉唑、奥曲肽和凝血酶联合治疗肝硬化并发食管胃底静脉曲张破裂出血患者的临床疗效。【方法】前瞻性选择2018年4月至2021年4月本院收治的88例肝硬化并发食管胃底静脉曲张破裂出血患者,采用随机双盲法将其分为观察组和对照组,每组各44例。对照组给予奥美拉唑以及奥曲肽治疗,观察组在对照组的基础上给予凝血酶治疗。比较两组患者的治疗效果,同时观察两组患者止血时间、输血量、症状缓解时间、住院时间以及不良反应发生情况。【结果】对照组患者治疗总有效率为77.27%(34/44),显著低于观察组的93.18%(41/44),差异有统计学意义(χ^(2)=4.423,P=0.035<0.05)。观察组止血时间、症状改善时间、住院时间均短于对照组,输血量低于对照组,差异均有统计学意义(P<0.05)。对照组不良反应发生率为9.09%(4/44),高于观察组的4.55%(2/44),但差异无统计学意义(χ^(2)=4.062,P=0.443>0.05)。【结论】奥美拉唑、奥曲肽和凝血酶联合治疗肝硬化并发食管胃底静脉曲张破裂出血患者的临床疗效较好,止血效果较佳,同时治疗安全性好,有利于改善患者预后。

【Objective】To investigate the clinical efficacy of omeprazole,octreotide and thrombin in the treatment of liver cirrhosis complicated with esophageal and gastric variceal bleeding.【Methods】A total of 88 patients with liver cirrhosis complicated with esophageal and gastric variceal bleeding treated in our hospital from April 2018 to April 2021 were prospectively selected.They were randomly divided into observation group and control group,with 44 cases in each group.The control group was treated with omeprazole and octreotide,and the observation group was treated with thrombin on the basis of the control group.The therapeutic effects of the two groups were compared,and the hemostasis time,blood transfusion volume,symptom relief time,hospital stay and adverse reactions were observed.【Results】The total effective rate of the control group was 77.27%(34/44),which was significantly lower than 93.18%(41/44)in the observation group(χ^(2)=4.423,P=0.035<0.05).The hemostasis time,symptom improvement time and hospitalization time of the observation group were shorter than those of the control group,and the amount of blood transfusion was lower than that of the control group(P<0.05).The incidence of adverse reactions in the control group was 9.09%(4/44),which was higher than 4.55%(2/44)in the observation group,but the difference was not statistically significant(χ^(2)=4.062,P=0.443>0.05).【Conclusion】The combination of omeprazole,octreotide and thrombin in the treatment of liver cirrhosis complicated with esophageal and gastric variceal bleeding has good clinical efficacy,good hemostatic effect,good safety and good prognosis.