奥曲肽联合普萘洛尔治疗肝硬化引起上消化道出血的临床作用探讨

Clinical effect of octreotide combined with propranolol in treating upper gastrointestinal bleeding caused by cirrhosis of the liver

目的探讨奥曲肽联合普萘洛尔治疗肝硬化引起食管静脉曲张破裂出血患者的临床作用及血流动力学指标的影响。方法收集我院2016年3月至2018年3月于我科住院的肝硬化合并上消化道出血患者90例,按随机数字表法分为对照组46例和治疗组44例,两组患者均接受一般对症处理基础上,对照组患者接受静脉泵入奥曲肽医治干预;治疗组患者接受静脉泵入奥曲肽联合口服普萘洛尔,连续治疗1周。统计两组临床治疗效果及检测两组治疗前后脾静脉,门静脉内径以及血流量下降幅度。结果治疗组总有效率较对照组升高(χ^2=4.230,P<0.05),治疗后两组的脾静脉、门静脉内径均显著缩短,且治疗组短于对照组(P<0.05);治疗后两组门静脉、脾静脉血流量均显著降低,且治疗组低于对照组(P<0.05);结论奥曲肽联合普萘洛尔可显著改善该病患者的血流力学指标,降低其血流量,临床止血效果显著,再出血发生率显著降低,有良好安全性,值得临床推广。

Objective To investigate the clinical effect of octreotide combined with propranolol in the treatment of esophageal variceal bleeding caused by cirrhosis and the influence of hemodynamic parameters.Methods Ninety patients with cirrhosis complicated with upper gastrointestinal hemorrhage hospitalized in our hospital from March 2016 to March 2018 were divided into control group(46 cases)and treatment group(44 cases)according to random number table method.On the basis of general symptomatic treatment,patients in the control group received intravenous injection of octreotide,while patients in the treatment group received intravenous injection of octreotide combined with oral propranolol.Continuous treatment for 1 week.Statistical treatment effect of the two groups and detection of splenic vein,portal vein diameter and blood flow decline before and after treatment.Results The total effective rate of the treatment group was significantly higher than that of the control group(χ^2=4.230,P<0.05).After treatment,the diameter of splenic vein and portal vein in the two groups were significantly shortened,and the blood flow of portal vein and splenic vein in the treatment group was significantly lower than that of the control group(P<0.05),and the treatment group was significantly lower than that of the control group(P<0.05).Conclusion The hemodynamic indexes of patients with this disease can reduce their blood flow.The clinical hemostasis effect is remarkable.The incidence of rebleeding is significantly reduced.It has good safety and is worthy of clinical promotion.