肝硬化合并上消化道出血患者行内镜套扎联合生长抑素、奥美拉唑治疗效果及血清hs-CRP、皮质醇变化

Effect of endoscopic ligation combined with somatostatin and omeprazole in patients with cirrhosis complicated with upper gastrointestinal hemorrhage and changes of serum hs-CRP and cortisol

目的:探讨肝硬化合并上消化道出血患者行内镜套扎联合生长抑素、奥美拉唑治疗效果,并分析其血清hs-CRP、皮质醇变化。方法:选择2016年6月~2018年12月期间在医院接受治疗的100例肝硬化合并上消化道出血患者作为研究对象,随机分成两组:观察组(50例)和对照组(50例)。观察组患者应用内镜套扎术联合生长抑素、奥美拉唑予以治疗,对照组患者应用内镜套扎术予以治疗。比较两组的临床效果、止血效果、门静脉血流量变化、生化指标变化以及不良反应情况。结果:经过相应的治疗之后,观察组患者的总有效率为94.0%,明显高于对照组患者的80.0%;观察组患者的再出血率明显低于对照组,止血时间明显短于对照组;但在24h止血率、输血量方面,两组比较的差异无统计学意义;观察组患者治疗后的门静脉血流量明显低于对照组;观察组患者治疗后的血清hs-CRP、皮质醇水平明显低于对照组;两组在不良反应发生情况方面比较的差异无统计学意义。结论:肝硬化合并上消化道出血患者行内镜套扎联合生长抑素、奥美拉唑治疗,能够获得良好止血效果,且能显著降低门脉高压及血清hs-CRP、皮质醇水平。

Objective To investigate the effect of endoscopic ligation combined with somatostatin and omeprazole in patients with cirrhosis complicated with upper gastrointestinal hemorrhage,and to analyze the changes of serum hs-CRP and cortisol.Methods 100 patients with cirrhosis complicated with upper gastrointestinal hemorrhage who were treated in hospital from June 2016 to December 2018 were selected as subjects,which were divided into the observation group(50 cases)and control group(50 cases).Patients in the observation group were treated with endoscopic ligation combined with somatostatin and omeprazole,and patients in the control group were treated with endoscopic ligation.The clinical effects,hemostasis,portal blood flow changes,biochemical changes and adverse reactions between the two groups were compared.Results The total effective rate of the observation group was 94.0%,which was significantly higher than 80.0%of the control group.The rebleeding rate of the observation group was significantly lower than that of the control group,and the hemostasis time was significantly shorter than that of the control group.But there was no significant difference in the hemostatic rate at 24h and blood transfusion between the two groups.The portal vein blood flow of the observation group was significantly lower than that of the control group.The serum hs-CRP and cortisol levels in the observation group were significantly lower than those in the control group.There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion Endoscopic ligation combined with somatostatin and omeprazole for patients with cirrhosis complicated with upper gastrointestinal hemorrhage can achieve good hemostasis,and significantly reduce portal hypertension,serum hs-CRP and cortisol levels.