生长抑素联合普萘洛尔治疗肝硬化伴食管胃底静脉曲张破裂出血的临床研究

Observation the Effect of Somatostatin Combined with Propranolol on Hepatic Cirrhosis with Esophagogastric Varicosis Bleeding

目的:分析研究生长抑素联合普萘洛尔治疗肝硬化伴食管胃底静脉曲张破裂出血(EGVB)的效果。方法:选取2017年1月至2019年1月漯河市中医院收治的96例肝硬化伴EGVB患者,按照随机数字表法将其分为对照组和观察组,各48例。对照组给予生长抑素治疗,观察组在对照组治疗基础上给予普萘洛尔,比较两组患者的临床疗效。结果:观察组患者治疗总有效率为89.58%,高于对照组的72.92%,差异具有统计学意义(P<0.05)。观察组患者止血时间和输血量均少于对照组,差异具有统计学意义(P<0.05)。两组患者再出血率比较,差异无统计学意义(P>0.05)。观察组患者治疗24 h和治疗48 h时门静脉压(PVP)水平均低于对照组,差异具有统计学意义(P<0.05)。观察组患者治疗5 d后纤维蛋白原(FIB)、D–二聚体(D–D)水平均高于对照组,差异具有统计学意义(P<0.05)。观察组患者恶心呕吐、腹泻、心动过缓、低钠血症各不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。结论:生长抑素联合普萘洛尔可有效降低PVP,改善出血情况,提高肝硬化伴EGVB治疗效果。

Objective To observe the clinical effects of somatostatin combined with propranolol on hepatic cirrhosis with esophageal and gastric varicosis bleeding(EGVB).Methods A total of 96 patients with hepatic cirrhosis and EGVB admitted to Luohe Hospital of Traditional Chinese Medicine from January 2017 to January 2019 were selected and divided into a control group and an observation group according to random number table method,with 48 cases in each group.The control group was given somatostatin treatment,the observation group was given propranolol on the basis of treatment in the control group,and the clinical efficacy of the two groups was compared.Results The total effective rate of the observation group was 89.58%,which was higher than 72.92%of the control group,and the difference was statistically significant(P<0.05).The hemostatic time and blood transfusion volume in the observation group were less than those in the control group,the differences were statistically significant(P<0.05).There was no significant difference in rebleeding rate between the two groups(P>0.05).The portal vein pressure(PVP)level in the observation group was lower than those in the control group at 24 h and 48 h after treatment,the differences were statistically significant(P<0.05).The levels of fibrinogen(FIB)and D-dimer(D-D)in the observation group were higher than those in the control group after 5 days of treatment,and the differences were statistically significant(P<0.05).There were no significant differences in the incidence of nausea and vomiting,diarrhea,bradycardia and hyponatremia between the observation group and the control group(P>0.05).Conclusion Somatostatin combined with propranolol can effectively reduce PVP,improve bleeding and enhance the treatment effects of hepatic cirrhosis with EGVB.