三种方案治疗肝硬化合并上消化道出血的临床疗效

Comparison of the clinical effects of the three regimens on liver cirrhosis complicated with upper gastrointestinal hemorrhage

目的分析奥曲肽、垂体后叶素及联合用药三种不同治疗方案对肝硬化合并上消化道出血的临床疗效。方法选取肝硬化合并上消化道出血患者115例，根据用药方式不同分为奥曲肽组（37例）、垂体后叶索组（38例）、联合用药组（40例），观察三组患者的临床疗效及补液量、止血消耗时间、便血持续时间。结果三组临床疗效从高到低依次是联合用药组（92．5％）、奥曲肽组（72．9％）、垂体后叶素组（55．2％），差异均有统计学意义（P〈0．05）；每日补液量、便血持续时间、止血时间比较，联合用药组疗效最佳，其次为奥曲肽组，垂体后叶素组疗效最差（P〈0．05）；联合用药组不良反应总发生率为10．0％，与奥曲肽组（13．5％）比较差异未见统计学意义（P〉0．05），但两组与垂体后叶素组（36．8％）比较差异均有统计学意义（P〈0．05）。结论奥曲肽联合垂体后叶素治疗肝硬化合并上消化道出血疗效显著高于单独用药治疗，止血时间短、不良反应少，其中单独奥曲肽临床疗效优于垂体后叶素。

Objective To analyze the clinical effects of octreotide, pituitrin and combination medication on liver cirrhosis complicated with upper gastrointestinal hemorrhage. Methods Atotal of 115 patients with liver cirrhosis complicated with upper gastrointestinal hemorrhage in hospital were divided into octreotide group （37 cases）, pituitrin group （38 cases） and medicine combination group （40 cases）. The clinical curative effect, fluid infusion volume, duration of hemostasis and duration of hemafecia were observed. Results The ctinical efficacy of the three groups from high to low was the drug combination group （92. 5% ）, octreotide group （72.9%） and pituitrin group （55.2%） （P 〈0. 05） ; The daily fluid infusion volume, duration of hemostasis and duration of hemafecia in the drug combination group were less and shorter than those in octreotide group and pituitrin group （ P 〈 0. 05 ） ; The total inci- dence of adverse reactions in the drug combination group was 10. 0%, and that in the octreotide group was 13.5% （P 〉 0. 05 ）, compared with the incidence in pituitrin group （36. 8% ）, there were significant differences （P 〈 0. 05）. Conclusions The effect of octreotide combined with pituitrin is better than that of single drug on liver cirrhosis complicated with upper gastrointestinal hemorrhage. The duration of hemostasis is short, and adverse reaction is few.