奥美拉唑联合生长抑素治疗肝硬化并上消化道大出血的临床疗效  

Clinical Effect of Omeprazole combined with Somatostatin in the Treatment of Cirrhosis of Liver and Upper Gastrointestinal Bleeding

作　　者：柴小萍 何若琦[1] 殷德荣[1] 刘燕[1] 梅立峰[2] CHAI Xiao-ping HE Ruo-qi YIN De-rong L MEI Li-feng(People＇s Hospital of Hanzhong, Hanzhong, Shaanxi, 723000, China Affiliated Hospital ofShaanxi University of Chinese Medicine, Hanzhong, Shaanxi, 723000, China)

机构地区：[1]陕西省汉中市人民医院,陕西汉中723000 [2]陕西中医学院附属医院,陕西汉中723000

出　　处：《现代生物医学进展》2016年第35期6876-6879,共4页Progress in Modern Biomedicine

基　　金：陕西省社发攻关(科学技术研究发展计划)项目(2012K13-01-10)

摘　　要：目的：探讨垂体后叶素、奥美拉唑联合生长抑素与垂体后叶素联合三腔两囊压迫止血治疗肝硬化并上消化道大出血的临床疗效及安全性。方法：收集58例于我院治疗的肝硬化并上消化道大出血患者。随机分为A组和B组,每组各29例。两组患者均给予保肝、输血、禁食、补充血容量。A组给予垂体后叶素50 U 0.1 u/min维持静滴,加用三腔两囊管压迫止血进行治疗;B组给予垂体后叶素50 U 0.1 u/min维持静滴,0.1～0.2 mg生长抑素加入20 m L生理盐水静脉缓慢推注,继以0.2 mg生长抑素以25～50μg/h静脉滴入,同时静脉滴注奥美拉唑40 mg,2次/日。治疗结束后,比较两组患者临床总有效率、不良反应发生率、止血时间及输血量。结果：与A组患者相比较,B组患者的临床总有效率、不良反应发生率、止血时间及输血量水平较低,差异具有统计学意义（P〈0.05）。结论：垂体后叶素、奥美拉唑联合生长抑素治疗肝硬化并上消化道大出血患者比垂体后叶素联合三腔两囊压迫止血治疗的临床总有效率高,不良发应少,止血时间短,输血量少。Objective： To compare the clinical effect and safety of octreotide and omeprazole combined with somatostatin and vasopressin combined with three cavities and two capsule compression hemostasis in the treatment of cirrhosis of the liver and upper gas- trointestinal bleeding. Methods： 58 patients with cirrhosis of liver and upper gastrointestinal bleeding from our hospital were selected and randomly divided into the group A and the group B with 29 cases in each group. Two groups of patients were treated with liver, blood transfusion, fasting, supplement blood capacity. Group A was treated by Vasopressin 50 U 0.1 u/min remained stationary and three cavity two cystic duct compression hemostasis. Group B was treated by Vasopressin 50 U 0.1 u/min remained stationary, 0.1-0.2 mg somatostatin by adding 20 mL normal saline intravenously, 0.2 mg somatostatin with 25 to 50 g/h intravenous infusion, and intravenous infusion of omeprazole 40 mg, 2 times / day. The total clinical effective rate, incidence of adverse reactions, bleeding time and blood transfusion were compared between two groups after treatment. Results： Compared with the group A, the total clinical effective rate was siginificantly higher, incidence of adverse reactions, hemostasis time and blood transfusion volume levels were all obviously lower in group B （P〈0. 05）. Conclusions： Posterior pituitrin, omeprazole combined with somatostatin had higher clinical efficacy and safety in the treatment of liver cirrhosis combined with upper gastrointestinal hemorrhage patients than vasopressin combined with three cavities and two capsule compression hemostasis.

关 键 词：肝硬化 垂体后叶素 上消化道大出血 奥美拉唑 生长抑素 

分 类 号：R575.2[医药卫生—消化系统]