大剂量奥曲肽联合兰索拉唑治疗肝硬化合并上消化道出血的临床效果观察

Clinical Effect of High-dose Octreotide Combined with Lansoprazole in the Treatment of Liver Cirrhosis with Upper Gastrointestinal Hemorrhage

目的探讨大剂量奥曲肽联合兰索拉唑治疗肝硬化合并上消化道出血的临床效果。方法选取2015年10月—2017年6月间佳木斯市传染病院收治的肝硬化合并上消化道出血患者96例,利用随机数表法分为两组,每组患者48例。两组均使用相同剂量兰索拉唑,对照组联合小剂量奥曲肽治疗,观察组联合大剂量奥曲肽治疗,对比两组临床疗效、门静脉平均流速(PVV)、门静脉内径(PVD)、止血时间及再出血情况。结果观察组治疗总有效率较对照组高,止血时间较对照组短,再出血发生率较对照组低,差异有统计学意义;治疗后,两组患者PVV、PVD均改善,与治疗前相比,差异有统计学意义;治疗后观察组PVV、PVD相比,差异无统计学意义。结论大剂量奥曲肽联合兰索拉唑治疗肝硬化合并上消化道出血可有效提升临床疗效,缩短止血时间,降低再出血发生率。

Objective To investigate the clinical effect of high-dose octreotide combined with lansoprazole in the treatment of liver cirrhosis with upper gastrointestinal hemorrhage. Methods 96 patients with liver cirrhosis complicated with upper gastrointesti- nal hemorrhage from October, 2015 to June, 2017 were selected. Patients were randomly divided into two groups, with 48 patients in each group. The two groups were treated with the same dose of lansoprazole. Control group received low dose octreotide, and observa- tion group received high dose octreotide. The clinical efficacy of the two groups was compared. The mean velocity of portal vein （PVV）, portal vein diameter （PVD）, hemostasis time and rebleeding were observed. Results The total effective rate of treatment in the observation group was higher than that in the control group. The hemostasis time was shorter, and the incidence of rebleeding was lower in the radiation group than that in the control group. There was statistically significant difference. After treatment, the PVD of PVV was improved in both groups. After treatment, there was no statistical significance of PVV and PVD in observation group. Conclusion High dose octreotide combined with lansoprazole in the treatment of liver cirrhosis with upper gastrointestinal bleeding can effectively improve the clinical efficacy, shorten the hemostatic time, and reduce the incidence of rebleeding.