特利加压素联合生长抑素及内镜止血治疗肝硬化食管胃静脉曲张出血的临床观察

Clinical Observation of terlipressin combined with somatostatin and endoscopic hemostasis in the treatment of esophagogastric variceal bleeding in liver cirrhosis

目的:观察特利加压素联合生长抑素及内镜止血治疗肝硬化食管胃静脉曲张出血(EGVB)的临床疗效及止血效果。方法:选取2021年1月—2023年12月本院收治的100例EGVB患者,按随机数字表法分为两组各50例。对照组给予0.25μg/h生长抑素微量泵持续泵入,维持24~72 h,同时进行内镜止血;观察组在对照组基础上加用特利加压素,首剂静脉注2 mg,后以0.125 mg/h特利加压素微量泵持续泵入,维持24~72 h,直到出血有效控制。比较两组临床疗效、止血效果、营养指标、并发症及不良反应。结果:观察组和对照组治疗总有效率分别为94.00%和80.00%,差异有统计学意义(P<0.05);观察组24 h止血成功率高于对照组,完全止血时间短于对照组,输血量少于对照组,差异均有统计学意义(P<0.05);治疗前两组血红蛋白(Hb)、白蛋白(ALB)比较差异无统计学意义(P>0.05),治疗后两组Hb和ALB均高于治疗前(P<0.05),且观察组Hb和ALB高于对照组,差异有统计学意义(P<0.05);两组并发症、不良反应比较差异无统计学意义(P>0.05)。结论:特利加压素联合生长抑素及内镜止血可快速止血,能够改善EGVB患者的营养状态,且无严重并发症及不良反应,值得临床推广应用。

Objective:To observe the clinical efficacy and hemostatic effect of terlipressin combined with somatostatin and endoscopic hemostasis for the treatment of esophagogastric variceal bleeding(EGVB)in liver cirrhosis.Methods:A total of 100 patients with EGVB admitted to our hospital between January 2021 and December 2023 were selected and divided into two groups according to the random number table method,with 50 patients in each group.The control group was given 0.25μg/h somatostatin continuously pumped by a microinfusion pump for 24~72 hours;endoscopic hemostasis was also performed.The observation group was additionally administered terlipressin compared to the control group.The initial dose was 2 mg intravenously,and then 0.125 mg/h terlipressin was continuously pumped by a microinfusion pump for 24~72 hours until bleeding was effectively controlled.Clinical efficacy,hemostatic effect,nutritional indicators,complications,and adverse reactions were compared between the two groups.Results:The total effective treatment rates in the observation and control groups were 94.00%and 80.00%,respectively,and the difference was statistically significant(P<0.05).The success rate of hemostasis within 24 h in the observation group was higher than that in the control group;the complete hemostasis time was shorter than that in the control group;and the blood transfusion volume was less than that in the control group,and the differences were statistically significant(P<0.05).Before treatment,there was no difference in the hemoglobin(Hb)and albumin(ALB)levels between the two groups(P>0.05).After treatment,Hb and ALB levels in both groups were higher than those before treatment(P<0.05),and Hb and ALB levels in the observation group were significantly higher than those in the control group(P<0.05).There were no differences in complications or adverse reactions between the two groups(P>0.05).Conclusion:Terlipressin combined with somatostatin and endoscopic hemostasis can quickly stop bleeding and improve the nutritional status of patients with EGVB,and there are no serious complications and adverse reactions that are worthy of clinical promotion and application.