卡维地洛联合生长抑素治疗肝硬化食管胃底静脉曲张破裂出血患者的效果

Effects of Carvedilol combined with Somatostatin in the treatment of esophageal and gastric varices bleeding in patients with liver cirrhosis

目的:观察卡维地洛联合生长抑素治疗肝硬化食管胃底静脉曲张破裂出血患者的效果。方法:回顾性分析2019年1月至2023年2月该院收治的75例肝硬化食管胃底静脉曲张破裂出血患者的临床资料,按照治疗方法不同将其分为对照组(n=37)和观察组(n=38)。两组均予以常规治疗,在此基础上,对照组予以生长抑素治疗,观察组在对照组基础上联合卡维地洛治疗。比较两组临床指标(止血时间、住院时间和输血量)水平、治疗前后门静脉指标(门静脉压、门静脉血流速度、门静脉血流量)水平、不良反应发生率和再出血发生率。结果:观察组止血时间、住院时间均短于对照组,输血量少于对照组,差异有统计学意义(P<0.05);治疗后,两组门静脉压、门静脉血流速度、门静脉血流量均低于治疗前,且观察组低于对照组,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);观察组再出血发生率为7.89%(3/38),低于对照组的27.03%(10/37),差异有统计学意义(P<0.05)。结论:卡维地洛联合生长抑素治疗肝硬化食管胃底静脉曲张破裂出血患者可改善临床指标水平,降低门静脉指标水平和再出血发生率,效果优于单纯生长抑素治疗。

Objective:To observe effects of Carvedilol combined with Somatostatin in the treatment of esophageal and gastric varices bleeding in patients with liver cirrhosis.Methods:The clinical data of 75 liver cirrhosis patients with esophageal and gastric varices bleeding admitted to this hospital from January 2019 to February 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group(n=37)and observation group(n=38).Both groups were given routine treatment.On this basis,the control group was treated with Somatostatin,while the observation group was treated with Carvedilol on the basis of that of the control group.The levels of clinical indexes(hemostasis time,hospitalization time and blood transfusion volume),the portal vein indexes(portal vein pressure,portal vein blood flow velocity and portal vein blood flow volume)levels before and after the treatment,the incidence of adverse reactions,and the incidence of rebleeding were compared between the two groups.Results:The hemostasis time and the hospitalization time of the observation group were shorter than those of the control group,the blood transfusion volume was less than that of the control group,and the differences were statistically significant(P<0.05).After the treatment,the portal vein pressure,the portal vein blood flow velocity and the portal vein blood flow in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).The incidence of rebleeding in the observation group was 7.89%(3/38),which was lower than 27.03%(10/37)in the control group,and the difference was statistically significant(P<0.05).Conclusions:Carvedilol combined with Somatostatin in the treatment of the liver cirrhosis patients with esophagogastric variceal bleeding can improve the level of clinical indexes and reduce the levels of portal vein indexes and the incidence of rebleeding.Moreover,it is superior to single Somatostatin treatment.