生长抑素联合埃索美拉唑治疗肝硬化合并上消化道出血临床观察  

Clinical Observation of Somatostatin Combined with Esomeprazole in Treatment of Patients with Liver Cirrhosis Complicated by Upper Gastrointestinal Hemorrhage

作　　者：何兴兵[1] 李强 刘世祥 HE Xing-bing;LI Qiang;LIU Shi-xiang(Emergency Department, Central Hospital of Ankang, Ankang, Shaanxi 725000,China)

机构地区：[1]安康市中心医院急诊科,陕西安康725000

出　　处：《解放军医药杂志》2019年第4期90-93,97,共5页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

基　　金：陕西省自然科学基金资助项目(2017JM8084)

摘　　要：目的探讨生长抑素联合埃索美拉唑治疗肝硬化合并上消化道出血临床疗效及对血清炎性因子和皮质醇(COR)的影响。方法选取2014年2月—2017年2月收治的肝硬化合并上消化道出血74例,按治疗方法分为观察组和对照组,每组37例。对照组给予生长抑素治疗,观察组在对照组基础上联合埃索美拉唑治疗。比较2组临床疗效,观察2组止血时间及住院时间,检测2组血清超敏-C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)及COR水平,并记录2组治疗期间不良反应发生情况。结果观察组总有效率高于对照组(P <0. 05)。治疗后,观察组止血时间、住院时间均短于对照组,再出血率低于对照组(P <0. 05)。治疗后,2组血清hs-CRP、TNF-α与COR水平低于治疗前,且观察组低于对照组(P <0. 05,P <0. 01)。2组不良反应发生率比较差异无统计学意义(P> 0. 05)。结论生长抑素联合埃索美拉唑治疗肝硬化合并上消化道出血的临床疗效肯定,可有效抑制炎症反应过程,且安全性较高。Objective To investigate clinical efficacy of somatostatin combined with Esomeprazole in treatment of patients with liver cirrhosis complicated by upper gastrointestinal bleeding and its effects on serum inflammatory factors and cortisol (COR). Methods A total of 74 patients with liver cirrhosis complicated by upper gastrointestinal bleeding admitted during February 2014 and February 2017 were divided into observation group and control group ( n =37 in each group) according to therapeutic methods. Control group was treated with somatostatin, while observation group was added with Esomeprazole on the basis of treatment for control group. In two groups, clinical efficacy was compared;hemostasis and hospitalization times were observed;serum levels of high sensitivity C-reactive protein (hs-CRP), tumor necrosis factor-α(TNF-α) and cortisol (COR) were detected;incidence rates of adverse reactions during treatment were also recorded. Results The total effective rate in observation group was significantly higher than that in control group ( P <0.05). After treatment in observation group, hemostasis and hospitalization times were significantly shorter, while rebleeding rate was significantly lower than those in control group ( P <0.05). After treatment, serum hs-CRP, TNF-α and COR levels were significantly lower than those before treatment in two groups, and the levels in observation group were significantly lower than those in control group ( P <0.05, P <0.01). There was no significant difference in incidence rate of adverse reactions between two groups ( P >0.05). Conclusion Somatostatin combined with Esomeprazole in treatment of patients with liver cirrhosis complicated by upper gastrointestinal bleeding has definitely clinical effect, and it may effectively inhibit inflammatory reaction process with good safety.

关 键 词：肝硬化 上消化道出血 生长抑素 埃索美拉唑 

分 类 号：R575.2[医药卫生—消化系统] R573.2[医药卫生—内科学]