醋酸奥曲肽联合硝酸甘油治疗肝硬化继发上消化道出血的临床效果观察

Clinical effect observation of octreotide acetate combined with nitroglycerin treating cirrhosis complicated with the upper gastrointestinal bleeding

目的探讨醋酸奥曲肽联合硝酸甘油治疗肝硬化继发上消化道出血的临床效果。方法选取本院2012年1月-2014年1月收治的肝硬化继发上消化道出血患者80例,采用双盲法将患者分为观察组和对照组。两组均给予常规治疗,对照组在常规治疗基础上给予醋酸奥曲肽治疗,观察组在对照组基础上加用硝酸甘油治疗,比较两组的临床疗效。结果观察组的总有效率为95.0%,显效时间、停止出血时间分别为（5.62±1.24）、（10.36±2.38）h,治疗后的门静脉、脾静脉血流量分别为（546.5±169.3）、（256.3±103.2）ml/min,与对照组比较,差异有统计学意义（P〈0.05）;两组治疗期间均未发生严重不良反应。结论醋酸奥曲肽联合硝酸甘油治疗肝硬化继发上消化道出血可快速止血、降低门脉压力,达到有效控制出血的目的 ,效果显著。

Objective To investigate the clinical effect of octreotide acetate combined with nitroglycerin treating cirrhosis complicated with the upper gastrointestinal bleeding. Methods 80 patients with cirrhosis complicated with the upper gastrointestinal bleeding admitted into our hospital from January 2012 to January 2014 were selected,and they were divided into the observation group and control group according to double-blind method.The two group were given the conventional treatment,the control group was treated with octreotide acetate on the basis of the conventional treatment,the observation group was treated with nitroglycerin on the basis of the control group,the curative effect in the two groups was compared. Results In the observation group,the total effective rate was 95.0%,the markedly effective time and the time of bleeding stop was（5.62±1.24） h and（10.36±2.38） h respectively,portal blood flow and splenic vein blood flow after treatment was（546.5±169.3） ml/min and（256.3±103.2） ml/min respectively,and there was a statistical difference of above-mentioned indicators in the two groups（P〈0.05）.There were no serious adverse events occurred in the two groups during treatment. Conclusion Octreotide acetate combined with nitroglycerin treating cirrhosis complicated with the upper gastrointestinal bleeding has a significant effect,and can quickly stop bleeding,reduce portal pressure to achieve the purpose of effective control of bleeding.