特利加压素联合奥美拉唑治疗肝硬化上消化道出血的临床研究

Clinical study of terlipressin combined with omeprazole in the treatment of upper gastrointestinal bleeding in liver cirrhosis

目的探讨特利加压素联合奥美拉唑治疗肝硬化上消化道出血的临床疗效。方法选取2017年8月至2020年8月本院收治的88例肝硬化上消化道出血患者作为研究对象,按照数字随机方法分为对照组与观察组,每组44例。对照组予以奥美拉唑治疗,观察组在对照组基础上联合特利加压素治疗,比较两组临床疗效、血流动力学指标、血清学指标及临床指标。结果观察组治疗总有效率为95.45%,高于对照组的81.82%,差异有统计学意义(P<0.05)。治疗后,观察组脾静脉内径、门静脉内径均短于对照组,脾静脉血流、门静脉血流均慢于对照组,差异有统计学意义(P<0.05)。治疗后,观察组一氧化氮(NO)、胰高血糖素、皮质醇、超敏C反应蛋白(hs-CRP)水平均低于对照组,差异有统计学意义(P<0.05)。观察组输血量少于对照组,止血时间短于对照组,肝静脉楔嵌压(WHVP)、游离肝静脉压(FHVP)水平均低于对照组,差异有统计学意义(P<0.05)。结论特利加压素联合奥美拉唑治疗肝硬化上消化道出血效果确切,可缩短止血时间,改善机体血流动力学及血清学指标,促进患者康复,值得临床推广应用。

Objective To investigate the clinical efficacy of terlipressin combined with omeprazole in the treatment of upper gastrointestinal bleeding in liver cirrhosis.Methods A total of 88 patients with upper gastrointestinal bleeding in liver cirrhosis admitted to our hospital from August 2017 to August 2020 were selected as the research subjects,and they were divided into the control group and the observation group according to ran-dom number table method,with 44 cases in each group.The control group was treated with omeprazole,and the observation group was treated with terlipressin on the basis of the control group,the clinical efficacy,hemodynamic indexes,serological indexes and clinical indexes were compared be-tween the two groups.Results The total effective rate in the observation group was 95.45%,which was higher than 81.82%in the control group,the difference was statistically significant(P<0.05).After treatment,the internal diameter of splenic vein and portal vein in the observation group were shorter than those in the control group,while the blood flow of splenic vein and portal vein in the observation group were slower than thpse in the control group,and the differences were statistically significant(P<0.05).After treatment,the levels of nitric oxide(NO),glucagon,cortisol and hy-persensitive C-reactive protein(hs-CRP)in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).The average blood transfusion volume in observation group was lower than that in the control group,the average hemostatic time was shorter than that in the control group,and the levels of wedged hepatic vein pressure(WHVP)and free hepatic venous pressure(FHVP)were lower than control group,the differences were statistically significant(P<0.05).Conclusion Terlipressin combined with omeprazole is effec-tive in the treatment of upper gastrointestinal bleeding in liver cirrhosis,whihc can shorten the hemostatic time,improve the hemodynamics and sero-logical indexes of the body,and promote the rehabilitation of patients,and is worthy of clinical promotion and application.