应用生长抑素与泮托拉唑联合治疗肝硬化合并上消化道出血患者的疗效及安全性分析  

Clinical Efficacy and Safety of Somatostatin Combined with Pantoprazole in Patients with Cirrhosis Complicated with Upper Gastrointestinal Bleeding

作　　者：黄晓丽[1] 冯凯祥[1] Huang Xiaoli;Feng Kaixiang(Department of Gastroenterology, Mianyang Central Hospital, Mianyang 621000, China)

机构地区：[1]绵阳市中心医院消化内科

出　　处：《成都医学院学报》2019年第3期317-321,共5页Journal of Chengdu Medical College

基　　金：四川省科技厅资助项目(No:2015140414)

摘　　要：目的探讨生长抑素联合泮托拉唑治疗肝硬化合并上消化道出血(upper gastrointestinal bleeding,UGIB)的临床效果。方法选取138例肝硬化合并UGIB患者为受试对象,按照随机数字表分为试验组与对照组每组69例。对照组给予生长抑素,试验组在其基础上联合泮托拉唑进行治疗。比较治疗前及治疗24、48、72 h后,两组急性时相反应程度:血清超敏C反应蛋白(hsCRP)、UGIB危急程度[Glasgow-Blatchford评分系统(GBS)]、血红蛋白(Hb)水平变化,分析治疗72 h后两组治疗效果、转归情况及疗程内药物不良反应发生率差异。结果治疗24、48、72 h后,两组血清hsCRP水平及GBS评分均较治疗前明显下降,且试验组明显低于同期对照组,差异均有统计学意义( P <0.05;试验组Hb水平与治疗前比较差异无统计学意义( P >0.05),但均明显高于同期对照组,差异均有统计学意义( P <0.05)。治疗72 h后,试验组治疗效果明显优于对照组,差异有统计学意义( P <0.05)。试验组输血量、止血时间、血尿素氮(BUN)恢复正常时间、转内镜治疗例数及住院时间均明显少于对照组,差异均有统计学意义( P <0.05),但两组二次出血例数比较差异无统计学意义( P >0.05)。疗程内,两组各项药物不良反应发生率比较差异均无统计学意义( P >0.05)。结论生长抑素联合泮托拉唑应用于肝硬化合并UGIB能获得较理想的治疗效果,其药物不良反应发生率与单药相近,安全性较突出。Objective To explore the clinical efficacy of somatostatin combined with pantoprazole in the treatment of cirrhosis complicated with upper gastrointestinal bleeding (UGIB).Methods A total of 138 patients with cirrhosis complicated with upper gastrointestinal bleeding were selected as the subjects and divided into the experiment group and control group according to the random number table with 69 cases in each group.The control group was treated with somatostatin and the experiment group was given somatostatin combined with pantoprazole.The degrees of acute phase reactions including serum hypersensitivity C-reactive protein (hsCRP), the UGIB severity by the Glasgow-Blatchford Scale (GBS) and the levels of hemoglobin (Hb) before treatment, 24, 48 and 72 hours after treatment were compared respectively.The therapeutic effect and prognosis after 72 hours of treatment and the incidence of adverse drug reactions during treatment were analyzed in the two groups.Results The serum hsCRP levels and GBS scores 24, 48 and 72 hours after treatment were significantly lower than those before treatment in the two groups ( P <0.05), and those were significantly lower in the experiment group than in the control group ( P <0.05).The Hb level after treatment was not significantly different from that before treatment in the experiment group ( P >0.05), but that in the experiment group was significantly higher than that in the control group ( P <0.05).The therapeutic effect of the experiment group was significantly better than that of the control group after 72 hours of treatment ( P <0.05).The blood transfusion volume, hemostasis time, normal recovery time of blood urea nitrogen (BUN), number of the cases treated by endoscopy and hospital stay in the experiment group were significantly less than those in the control group ( P <0.05), while there was no significant differences in the number of the cases with secondary bleeding between the two groups ( P >0.05).There was no significant differences in the incidence of adverse drug react

关 键 词：肝硬化 上消化道出血 生长抑素 泮托拉唑 

分 类 号：R575.2[医药卫生—消化系统]