普萘洛尔联合奥曲肽治疗肝硬化上消化道出血的临床疗效以及对患者生活质量的影响

The effect of propranolol combined with octreotide on clinical efficacy and quality of life in cirrhosis patients with upper digestive tract hemorrhage

[目的]观察普萘洛尔联合奥曲肽治疗肝硬化上消化道出血的临床疗效以及其对患者生活质量的影响。[方法]选取我院2014年3月~2016年9月住院治疗的肝硬化肝硬化上消化道出血患者128例,使用随机数字法分为对照组和观察组,每组64例。比较2组的止血时间和输血量。彩色多普勒超声显像仪测定门静脉内径和门静脉血流量,生活质量(QOL)量表评价患者治疗前后的生活质量。比较2组临床疗效和不良反应发生率。[结果]观察组平均止血时间为(21.62±5.17)h,显著短于对照组的(32.87±7.21)h(P<0.05)。观察组平均输血量为(1.62±0.45)U,显著少于对照组的(2.52±0.64)U(P<0.05)。治疗前2组门静脉内径和门静脉血流量无显著性差异无统计学意义(P>0.05),治疗后观察组门静脉内径和门静脉血流量均显著低于对照组(P<0.05)。治疗前2组躯体功能、角色功能、认知功能、情绪功能、社会功能、整体功能生存质量评分差异无统计学意义(P>0.05),治疗后观察组上述生存质量指标评分均显著高于对照组(P<0.05)。观察组的有效率为92.2%(59/64),显著高于对照组的73.4%(47/64)(P<0.05)。观察组不良反应发生率为9.4%(6/64),对照组不良反应发生率为7.8%(5/64),2组不良反应差异无统计学意义(P>0.05)。[结论]普萘洛尔联合奥曲肽治疗肝硬化上消化道出血,使血流动力学指得到显著改善,提高临床疗效并改善患者的生活质量,临床使用安全。

[Objective]To observe the effect of propranolol combined with octreotide on clinical efficacy and quality of life in cirrhosis patients with upper digestive tract hemorrhage. [Methods]128 cirrhosis pa- tients with upper digestive tract hemorrhage were sellected in this study. The patients were divided into： control group（n = 64）and observation group （n = 64）. The hemostatic time and blood transfusion valume were compared between the two groups. The diameter of portal vein and portal vein blood flow were measured by color Doppler flow imaging. Quality of life（QOL）scale was used to evaluate the quality of life of patients before and after treatment. The clinical effect and adverse reaction rate were compared between the two groups. [Results]The average hemostasis time in observation group was 21.62±5.17 h,which was significantly shorter than that of 32. 87±7.21 h in control group（P〈0.05）. The average blood transfusion valume in observation group was 1.62±0.45 U,which was significantly less than that of 2.52±0.64 U in control group（P〈0.05）. There was no significant difference in the diameter of portal vein and portal vein blood flow between the two groups before treatment. After treatment, they were both lower in observation group than that in control group（P〈0.05）. There was no significant difference of physical function, role function, cognitive function, emotional function, social function, global function scores between the two groups before treatment. After treatment, they were all higher in observation group than that in control group（P〈0.05）. The clinical effect was 92.2% （59/64）in observation group, which was higher than that of 73.4%（47/64） in control group. The rate of adverse reaction was 9.4% （6/64）in observation group and 7.8% （5/64）in control group. There was no significant difference between the two groups（P〉0.05）. [Conelusion]Propranolol combined with octreotide improved hemodynamics, quality of life, and clinical efficacy in treatment of liver cirrhosis with upper gastrointestinal bleeding, with clinical use of safety.