特利加压素治疗失代偿期肝硬化并发肝腹水的效果分析

Therapeutic effects of terlipressin on decompensated cirrhosis complicated by hepatic ascites

目的探讨特利加压素治疗失代偿期肝硬化并发肝腹水的临床治疗效果。方法选取2017年5月至2018年8月收治的74例肝硬化并肝腹水患者为研究对象,按随机数字表法将患者均分为观察组与对照组,每组37例。对照组采用常规治疗,观察组在对照组基础上给予特利加压素治疗,2组均治疗14 d。比较2组临床疗效,治疗前后腹围、24 h尿量、门静脉和脾静脉内径及血流速度、生化指标及不良反应发生情况。结果治疗后观察组总有效率高于对照组,差异有统计学意义(P<0.05);治疗后,观察组腹围显著小于对照组,24 h尿量显著高于对照组,差异均有统计学意义(P<0.05);治疗后2组门静脉、脾静脉内径均小于治疗前,门静脉、脾静脉血流速度快于治疗前,差异有统计学意义(P<0.05);治疗后观察组门静脉、脾静脉内径小于对照组,血流速度高于对照组,差异均有统计学意义(P<0.05);治疗后,2组肌酐水平较治疗前显著降低,白蛋白及24 h尿钠水平较治疗前显著升高,差异有统计学意义(P<0.05);治疗后观察组肌酐水平显著低于对照组,白蛋白水平及24 h尿钠显著高于对照组,差异有统计学意义(P<0.05);2组均未见严重不良反应发生。结论特利加压素治疗失代偿期肝硬化并肝腹水的疗效理想,可有效改善患者的肾功能,减小门静脉、脾静脉内径,增加血流速度,减少腹水,且安全性高,具有良好临床应用价值。

Objective To investigate the clinical effects of terlipressin in the treatment of decompensated cirrhosis complicated with hepatic ascites.Methods Seventy-four patients with liver cirrhosis and hepatic ascites who were admitted and treated in our hospital from May 2017 to August 2018 were enrolled in the study.The patients were divided into observation group and control group according to the random number table method,with 37 cases in each group.The control group was treated with conventional therapy,and the observation group was treated with terlipressin on the basis of the control group.Both groups were treated for 14 d.The clinical efficacy,the abdominal circumference,24 h urine volume,diameter of portal vein and splenic vein and blood flow velocity,biochemical parameters and adverse reactions of the two groups were compared before and after treatment.Results After treatment,the total effective rate of the observation group was higher than that of the control group,and the difference was statistically significant(P<0.05).The abdominal circumference of the observation group was significantly smaller than that of the control group,and the 24 h urine volume was significantly larger than that of the control group after treatment.There were significant differences(P<0.05).After treatment,the diameters of portal vein and splenic vein were smaller than those before treatment,and the blood flow velocity of portal vein and splenic vein was faster than that before treatment.The difference was statistically significant(P<0.05).After treatment,the diameter of portal vein and splenic vein in the observation group was smaller than that in the control group,and the blood flow velocity was higher than that in the control group.The difference was statistically significant(P<0.05).The creatinine level of the two groups was significantly lower after treatment than before treatment.Albumin and 24 h urinary sodium level were significantly higher than those before treatment,and the difference was statistically significant(P<0.05).After treatment,the creatinine level of the observation group was significantly lower than that in the control group,while albumin level and 24 h urinary sodium was significantly higher than those in the control group.The difference was statistically significant(P<0.05).No serious adverse reactions occurred in either group.Conclusion Terlipressin is effective in treatment of decompensated cirrhosis and hepatic ascites.It can effectively improve the renal function of patients,reduce the diameter of portal vein and splenic vein,increase blood flow velocity,and reduce ascites.In addition,it has good safety,which is,therefore,of great application value in clinical practice.