生长抑素联合特利加压素治疗肝硬化上消化道出血的临床疗效分析  

Clinical analysis of somatostatin combined with terlipressin in the treatment of upper gastrointestinal bleeding in cirrhosis

作　　者：王鹏飞 WANG Peng-fei(Department of Gastroenterology,Nanping First Hospital,Nanping 353000,China)

机构地区：[1]南平市第一医院消化内科,353000

出　　处：《中国现代药物应用》2023年第11期22-26,共5页Chinese Journal of Modern Drug Application

摘　　要：目的 观察肝硬化上消化道出血患者采取生长抑素与特利加压素联合治疗的效果。方法 90例肝硬化上消化道出血患者,随机分为对照组和观察组,每组45例。对照组患者单纯采用生长抑素治疗,观察组患者采取生长抑素联合特利加压素治疗。比较两组患者临床指标(输血量、止血时长以及住院治疗总时长),治疗前后静脉血流速度(门静脉血流速度、脾静脉血流速度),治疗前后凝血指标[凝血酶原时间(PT)、活化的部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)]水平,临床疗效。结果 观察组患者的输血量(238.09±62.37)ml少于对照组的(393.58±56.23)ml,止血时长(19.97±3.14)h以及住院治疗总时长(7.97±1.44)d均短于对照组的(24.51±4.39)h、(12.63±2.27)d,差异均有统计学意义(P<0.05)。治疗前,两组患者的门静脉血流速度、脾静脉血流速度比较差异无统计学意义(P>0.05);治疗后,两组患者的门静脉血流速度、脾静脉血流速度小低于本组治疗前,观察组患者的门静脉血流速度(288.97±18.14)ml/min、脾静脉血流速度(551.97±52.44)ml/min均小于对照组的(303.56±17.39)、(594.63±48.27)ml/min,差异具有统计学意义(P<0.05)。治疗前,两组患者的PT、TT、APTT、FIB比较,差异无统计学意义(P>0.05);治疗后,对照组患者的TT短于本组治疗前,观察组患者的PT、TT、APTT均短于本组治疗前及对照组治疗后,FIB水平高于本组治疗前及对照组治疗后,差异具有统计学意义(P<0.05)。观察组临床治疗总有效率100.00%显著高于对照组的91.11%,差异具有统计学意义(P<0.05)。结论 生长抑素联合特利加压素用于肝硬化上消化道出血患者治疗中,临床疗效显著,能够减少输血量,缩短止血时长与住院治疗总时长,降低门静脉与脾静脉的血流速度,改善相关凝血指标水平,值得推荐。Objective To observe the effect of somatostatin combined with terlipressin in the treatment of upper gastrointestinal bleeding in cirrhosis.Methods A total of 90 patients with cirrhosis and upper gastrointestinal bleeding were randomly divided into control group and observation group,with 45 cases in each group.The control group was treated with somatostatin alone,and observation group was treated with somatostatin and terlipressin.Both groups were compared in terms of clinical indexes(amount of blood transfusion,duration of hemostasis and length of hospital stay),venous blood flow velocity(blood flow velocity in the portal vein and splenic vein)before and after treatment,and the levels of coagulation indexes[prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),prothrombin time(TT)]levels before and after treatment,and clinical efficacy.Results The amount of blood transfusion of(238.09±62.37)ml in the observation group was less than that of(393.58±56.23)ml in the control group;the duration of hemostasis of(19.97±3.14)h and length of hospital stay of(7.97±1.44)d in the observation group were shorter than those of(24.51±4.39)h and(12.63±2.27)d in the control group;the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in blood flow velocity in the portal vein and splenic vein between the groups(P>0.05).After treatment,the blood flow velocity in the portal vein and splenic vein in the two groups were less than those before treatment in this group;the blood flow velocity in the portal vein and splenic vein were(288.97±18.14)and(551.97±52.44)ml/min in the observation group,which were less than those of(303.56±17.39)and(594.63±48.27)ml/min in the control group;the differences were statistically significant(P<0.05).Before treatment,there was no statistically significant difference in PT,TT,APTT and FIB between the two groups(P>0.05).After treatment,TT in the control group was shorter than that before treatment in thi

关 键 词：生长抑素 特利加压素 肝硬化上消化道出血 

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