奥曲肽治疗肝炎后肝硬化上消化道出血的疗效分析

The Curative Effect Analysis of Octreotide in the Treatment of Cirrhosis Post Hepatitis with Upper Digestive Tract Hemorrhage

目的探讨奥曲肽治疗肝炎后肝硬化失代偿期所致上消化道出血的疗效和安全性。方法通过对照研究方法选60例上消化道出血的肝炎后肝硬化失代偿期患者随机按1∶1分为二组,每组30例,具有可比性(P>0.05)。A组:常规治疗,给予补液、输血、止血、抗感染、保肝、口服冰去甲肾上腺素生理盐水稀释液、K+Na+-ATP酶质子泵抑制剂应用及相应对症处理,并予奥曲肽0.1mg加入5%GS20mL中缓慢静脉注射,继之将奥曲肽注射液稀释后0.025mg/h持续微泵静脉注射3d。B组:在常规治疗基础上,将奥曲肽改用脑垂体后叶素120单位加硝酸甘油5mg稀释后24h内静脉滴注持续治疗3d。结果 A组总有效率93.3%,B组总有效率60.0%。A组不良反应发生率为3%,B组不良反应发生率为40%,两组疗效及不良反应相比有统计学差异(P<0.05)。结论奥曲肽治疗肝炎后肝硬化失代偿期所致上消化道出血的止血效果较脑垂体后叶素显著,患者安全性和耐受性良好,是值得推广的治疗方案。

Objective Study the curative effect and safety of octreotide in the treatment of decompensated liver cirrhosis after hepatitis caused by digestive tract hemorrhage. Methods Through comparative research methods 60 cases of hemorrhage of upper digestive tract in patients with decompensated liver cirrhosis after hepatitis were randomly divided by 1 ： 1 into two groups, 30 cases in each group, with comparable （P〉0.05）. Group A： conventional treatment, given the rehydration, blood transfusion, hemostatic, resistance to infection, liver, oral ice norepinephrine saline diluted solution, K＋Na＋-ATP enzyme proton pump inhibitor application and corresponding treatment, and to join the 5%GS 20mL oetreotide 0. lmg slow intravenous injection, afterwards will octreotide injection diluted 0.025mg/hours of continuous intravenous micro pump injection for 3 days. Group B： on the basis of routine treatment, will octreotide with Pituitrin plus nitroglycerin inl20 units of 5mg diluted within 24 hours after intravenous infusion of continuing treatment for 3 days. Results The total efficiency of 93.3% in A group, B group, the total efficiency of 60%. A group the incidence of side effects was 7% in B group, the incidence of side effects was 40%, two groups of efficacy and side effects compared with statistically significant difference （P〈0.05）. Conclusion Oetreotide in the treatment of post hepatitis cirrhosis decompensation of upper gastrointestinal hemorrhage caused by hemostatic effect than pituitrin significant, patients are safe and well tolerated, is worth promoting treatment options.