特利加压素不同输注方式治疗门静脉高压症所致急性食管胃底静脉曲张破裂出血的疗效比较  

Efficacies of different terlipressin infusion approaches for treating acute esophagogastric variceal bleeding caused by portal hypertension:a comparative study

作　　者：邹蕴[1] 胡晓霞[2] 努尔比亚·阿合衣提 韩峰[3] 徐丽 宛红娥[5] ZOU Yun;HU Xiao-xia;Nuerbiya Aheyiti;HAN Feng;XU Li;WAN Hong-e(Department of Gastroenterology,Xinjiang Military Command General Hospital,Urumchi 830000,China;Department of Geriatrics,Xinjiang Military Command General Hospital,Urumchi 830000,China;Department of Pharmacy,Xinjiang Military Command General Hospital,Urumchi 830000,China;Department of Radiotherapy,Xinjiang Military Command General Hospital,Urumchi 830000,China;Department of Radiology,Xinjiang Military Command General Hospital,Urumchi 830000,China)

机构地区：[1]新疆军区总医院消化科,乌鲁木齐市830000 [2]新疆军区总医院老年病科,乌鲁木齐市830000 [3]新疆军区总医院药剂科,乌鲁木齐市830000 [4]新疆军区总医院放疗科,乌鲁木齐市830000 [5]新疆军区总医院影像科,乌鲁木齐市830000

出　　处：《广西医学》2020年第22期2948-2951,2955,共5页Guangxi Medical Journal

摘　　要：目的比较特利加压素的不同输注方式治疗门静脉高压症(PH)所致的急性食管胃底静脉曲张破裂出血(AEVB)的疗效。方法将123例PH所致的AEVB患者随机分为持续组(n=62)和间歇组(n=61)。持续组给予特利加压素持续注射,间歇组给予特例加压素间歇注射,两组均治疗5 d。比较两组患者的疗效、止血时间、输血率、住院天数及随访期间再出血率、死亡率、药物不良反应发生率,分析影响患者再出血的危险因素。结果持续组治疗有效率高于间歇组,止血时间短于间歇组,输血率、再出血率低于间歇组(P<0.05),两组患者住院时间、死亡率及药物不良反应总发生率差异无统计学意义(P>0.05)。多因素分析结果显示,改良终末期肝病模型评分是患者发生再出血的独立危险因素,而持续输注特利加压素则是患者发生再出血的保护因素(P<0.05)。结论与间歇注射比较,持续输注特利加压素治疗PH所致的AEVB患者疗效更好,再出血率低,且安全性好。Objective To compared the efficacies of different terlipressin infusion approaches for treating acute esophagogastric variceal bleeding(AEVB)caused by portal hypertension(PH).Methods A total of 123 patients with AEVB due to PH were randomly divided into continuous group(n=62)and intermittent group(n=61).The continuous group was given continuous injection of terlipressin,while the intermittent group was given intermittent injection of terlipressin,and the course of treatment was five days in both groups.Efficacy,time to hemostasis,blood transfusion rate,hospital stay,as well as rebleeding rate,mortality rate,and incidence rate of adverse drug reactions during follow-up were compared between the two groups,and the risk factors influencing rebleeding in the patients were analyzed.Results Compared with the intermittent group,the continuous group obtained higher effective rate of treatment,shorter time to hemostasis,lower blood transfusion rate and rebleeding rate(P<0.05),there was no statistically significant difference in hospital stay,mortality rate or total incidence rate of adverse drug reactions between the two groups(P>0.05).Multivariate analysis results revealed that modified model for end-stage liver disease score was an independent risk factor for developing rebleeding in the patients,and continuous infusion of terlipressin was a protective factor for developing rebleeding in the patients(P<0.05).Conclusion Compared with intermittent injection,continuous infusion of terlipressin has a favorable efficacy for patients with AEVB due to PH,with a lower rebleeding rate and good safety.

关 键 词：急性食管胃底静脉曲张破裂出血 门静脉高压 特利加压素 再出血 影响因素 

分 类 号：R657.34[医药卫生—外科学]