特利加压素联合奥曲肽治疗肝硬化上消化道出血患者的效果

Effects of Terlipressin combined with Octreotide in treatment of patients with liver cirrhosis and upper gastrointestinal bleeding

目的:观察特利加压素联合奥曲肽治疗肝硬化上消化道出血患者的效果。方法:回顾性分析2020年1月至2022年3月该院收治的82例肝硬化上消化道出血患者的临床资料,根据治疗方法不同将其分为观察组(n=41)和对照组(n=41)。对照组给予奥曲肽治疗,观察组在对照组基础上联合特利加压素治疗,比较两组临床指标水平、治疗前后凝血指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)]水平、门静脉系统指标[门静脉内径(DPV)、脾静脉内径(DSV)、门静脉血流速度(VPV)及脾静脉血流速度(VSV)]水平、治疗期间不良反应发生率和临床疗效。结果:观察组止血时间短于对照组,输血量少于对照组,血红蛋白和血细胞比容水平均高于对照组,差异有统计学意义(P<0.05);治疗2 d后,两组PT、APTT、TT均短于治疗前,且观察组短于对照组,差异有统计学意义(P<0.05);治疗2 d后,两组DPV、DSV均小于治疗前,且观察组小于对照组,两组VPV、VSV均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);两组不良反应发生率比较,差异无统计学意义(P>0.05);观察组治疗总有效率为95.12%(39/41),高于对照组的80.49%(33/41),差异有统计学意义(P<0.05)。结论:特利加压素联合奥曲肽治疗肝硬化上消化道出血患者可提高治疗总有效率,改善临床指标和门静脉系统指标水平,降低凝血指标水平,效果优于单纯奥曲肽治疗。

Objective:To observe effects of Terlipressin combined with Octreotide in treatment of patients with liver cirrhosis and upper gastrointestinal bleeding.Methods:The clinical data of 82 patients with liver cirrhosis and upper gastrointestinal bleeding admitted to the hospital from January 2020 to March 2022 were retrospectively analyzed.According to different treatment methods,they were divided into observation group(n=41)and control group(n=41).The control group was treated with Octreotide,while the observation group was treated with Terlipressin on the basis of that of the control group.The levels of clinical indexes,the coagulation index levels[prothrombin time(PT),activated partial thromboplastin time(APTT),thrombin time(TT)],the portal venous system index levels[portal vein diameter(DPV),splenic vein diameter(DSV),portal vein blood flow velocity(VPV)and splenic vein blood flow velocity(VSV)]before and after the treatment,the incidence of adverse reactions during the treatment,and the clinical efficacy were compared between the two groups.Results:The hemostasis time of the observation group was shorter than that of the control group,the blood transfusion volume was less than that of the control group,the hemoglobin and hematocrit levels were higher than those of the control group,and the differences were statistically significant(P<0.05).After 2 days of treatment,the PT,APTT and TT in the two groups were shorter than those before the treatment,those in the observation group were shorter than those in the control group,and the differences were statistically significant(P<0.05).After 2 days of treatment,the DPV and DSV of the two groups were smaller than those before the treatment,and those in the observation group were smaller than those in the control group;the VPV and VSV of the two groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;and the differences were statistically significant(P<0.05).However,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The total effective rate of treatment in the observation group was 95.12%(39/41),which was higher than 80.49%(33/41)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Terlipressin combined with Octreotide in the treatment of the patients with liver cirrhosis and upper gastrointestinal bleeding can improve the total effective rate of treatment,improve the levels of clinical indexes and portal venous system indexes,and reduce the levels of coagulation indicators.Moreover,it is superior to single Octreotide treatment.