奥曲肽联合特利加压素治疗肝硬化食管静脉破裂出血疗效观察

CLINICAL OBSERVATION OF OCTREOTIDE COMBINED TERLIPRESSIN IN THE TREATMENT OF ACUTE ESOPHAGEAL VARICAL BLEEDING

目的观察奥曲肽联合特利加压素在治疗肝硬化食管静脉破裂出血患者的疗效。方法将该院肝硬化食管静脉曲张破裂出血患者94例随机分内奥曲肽组和联合治疗组,所有患者先应用奥曲肽（首剂静脉推注0.1mg,然后给予0.9%Nacl 50ml＋奥曲肽0.6mg持续q12h静脉泵入）,如24h后出血未停止,再随机分为二组,联合治疗组加上特利加压素（首剂静脉2mg后,间隔4h静脉注射1mg）,奥曲肽组加快给药速度（0.9%Nacl 50ml＋奥曲肽0.6mgq8h持续静脉泵入）,二组给药时间维持48-72h,观察二组出血停止时间,再出血率,病死率和不良反应。结果联合治疗组临床疗效高于奥曲肽组（P〈0.05）,联合治疗组不良反应有血压升高及心悸等,奥曲肽组不良反应有心率减慢,腹部痉挛性疼痛,均在减少用药量后缓解。结论奥曲肽联合特利加压素治疗肝硬化食管静脉曲张破裂出血疗效优于单用奥曲肽,且安全性好,但费用较高。

Objective To observe the clinical efficacy of Octreotide combined Terlipressin for acute esophageal varical bleeding in cirrhotic patients.Methods A total of 94 patients with acute esophageal varical bleeding were randomized into Octreotide group and combined treatment group.All patients were given intravenous injection of Octreotide 0.1mg,and then continuous infusion 0.9% Nacl 50ml＋ Octreotide 0.6mg for q12 h,such as the bleeding had not stopped after 24 h,and then were randomly divided into two groups：combined treatment group and Terlipressin group（intravenous injection 2mg,4h intravenous injection 1mg）,the dosage of the Octreotide group were increased（0.9% Nacl 50ml＋ Octreotide 0.6mg q8 h continuous infusion）.The time of injection was 48-72h in both group.The hemostasis duration,the incidence of rehaemorrhagia mortality and adverse drug reactions were compared between two groups.ResultsThe clinical curative effect of combined treatment group was higher than the Octreotide group（P 〈0.05）.The adverse reactions of combined treatment group were blood pressure and heart palpitations,while in Octreotide group were slow heart beat,abdominal spastic pain.Conclusion Clinical efficacy of Octreotide combined Terlipressin is better than the Octreotide alone in the acute esophageal varical bleeding,but the cost is higher.