维生素C联合奥曲肽治疗肝硬化消化道出血的效果

Effect of vitamin C and octreotide in the treatment of liver cirrhosis with gastrointestinal bleeding and influences on the targets of laboratory

目的探讨维生素C联合奥曲肽治疗肝硬化消化道出血的效果。方法回顾性分析2018年11月至2019年9月我院收治的144例肝硬化消化道出血患者资料,依照治疗方法进行分组,设置采用基础治疗+奥曲肽治疗方案的72例患者为对照组,设置采用基础治疗+奥曲肽+维生素C治疗方案的72例患者为研究组。统计两组止血时间、输血量,治疗前、治疗后的血清胆碱酯酶(CHE)、血清超氧化物歧化酶(SOD)、丙二醛(MDA)和肝功能指标[天冬氨酸转氨酶(AST)、丙氨酸氨基转移酶(ALT)、总胆红素(TBil)、直接胆红素(DBIL)],不良反应发生情况。结果对照组总有效率为84.72%,研究组为95.83%,研究组治疗效果优于对照组(P<0.05);对照组止血时间、输血量均高于研究组(P<0.05);治疗后,两组患者的CHE和SOD水平上升,MDA水平下降,且研究组上升/下降幅度大于对照组,组间差异有统计学意义(P<0.05);治疗后,两组患者的肝功能指标均下降,且研究组改善情况优于对照组,且组间差异有统计学意义(P<0.05)。研究组患者出现1例恶心反应,不良反应率为1.39%,与对照组(0.00%)差异无统计学意义(P>0.05)。结论在奥曲肽治疗肝硬化消化道出血的基础上加用维生素C可有效提高治疗效果,改善患者的肝功能,减少止血时间和输血量,安全性高。

Objective To investigate the effect of vitamin C+octreotide in the treatment of liver cirrhosis with gastrointestinal bleeding and influences on the targets of laboratory.Methods 144 cases of liver cirrhosis patients with gastrointestinal bleeding(November 2018 to September 2019)were selected and divided into groups according to the treatment methods.72 patients with basic treatment+octreotide treatment scheme were set as the control group,and 72 patients with basic treatment+octreotide+vitamin C treatment scheme were set as the study group.The hemostasis time,blood transfusion volume,Che,SOD,MDA and liver function indexes(AST,ALT,TBIL,DBIL)before and after treatment in the two groups were counted,and the incidence of adverse reactions was analyzed.Results The total effective rate of the control group was 84.72%,and that of the study group was 95.83%.The treatment effect of the study group was better than that of the control group(P<0.05);the hemostatic time and blood transfusion volume of the control group were higher than those of the study group(P<0.05);after treatment,the Che and SOD levels of the two groups increased,and the MDA level decreased,and the increase/decrease range of the study group was greater than that of the control group,with significant difference between the two groups(P<0.05);After treatment,liver function indexes of both groups decreased,and the improvement of the study group was better than that of the control group,with significant difference between the two groups(P<0.05).There was 1 case of nausea in the study group,the adverse reaction rate was 1.39%,and there was no significant difference compared with the control group(0.00%)(P>0.05).Conclusion On the basis of octreotide in the treatment of liver cirrhosis with gastrointestinal bleeding,vitamin C can effectively improve the treatment effect,and liver function,reduce the hemostasis time and blood transfusion volume with high safety.