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目的探讨醋酸奥曲肽联合奥美拉唑治疗肝硬化食管静脉曲张破裂出血的效果。方法选取2012年1月—2015年1月收治的肝硬化食管静脉曲张破裂首次出血患者100例作为研究对象,随机分为对照组和观察组各50例。对照组予以奥曲肽治疗,观察组在对照组的基础上予以埃索美拉唑治疗。记录两组止血成功、早期再出血和迟发性再出血发生情况,观察两组治疗前后内毒素、血清一氧化氮(NO)水平;观察两组不良反应发生情况。计量资料组间采用t检验,组内比较采用配对t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果观察组止血成功率为88.0%,高于对照组的72.0%,差异有统计学意义(P<0.05)。观察组与对照组治疗前NO及内毒素水平分别为(71.26±5.61)μmol/L、(0.61±0.20)Eu/ml、(72.49±6.33)μmol/L、(0.59±0.16)Eu/ml,治疗后分别为(45.16±9.51)μmol/L、(0.34±0.11)Eu/ml、(53.64±12.85)μmol/L、(0.45±0.29)Eu/ml,两组治疗前后比较差异均有统计学意义(均P<0.05)。且治疗后两组比较差异均有统计学意义(均P<0.05)。结论醋酸奥曲肽联合埃索美拉唑治疗肝硬化食管静脉曲张破裂出血,可改善血管内皮功能,提高止血成功率。
Objective To investigate the effect of octreotide acetate combined with omeprazole in the treatment of hepatic cirrhosis with esophageal variceal bleeding. Methods A total of 100 patients with primary hemorrhagic esophageal varices with cirrhosis who were admitted from January 2012 to January 2015 were randomly divided into control group and observation group of 50 cases. The control group was treated with octreotide, the observation group was treated with esomeprazole on the basis of the control group. The success of hemostasis, early rebleeding and delayed rebleeding were recorded. The levels of endotoxin and serum nitric oxide (NO) were observed before and after treatment. The incidence of adverse reactions in both groups were observed. The t test was used to measure the data group, the paired t test was used in the group, and the χ2 test was used to count data. The difference was statistically significant at P <0.05. Results The success rate of hemostasis in observation group was 88.0%, which was higher than that in control group (72.0%), the difference was statistically significant (P <0.05). The levels of NO and endotoxin before treatment in observation group and control group were (71.26 ± 5.61) μmol / L, (0.61 ± 0.20) Eu / ml, (72.49 ± 6.33) μmol / L and (0.59 ± 0.16) Eu / (45.16 ± 9.51) μmol / L, (0.34 ± 0.11) Eu / ml and (53.64 ± 12.85) μmol / L and (0.45 ± 0.29) Eu / ml respectively after treatment.The difference between before and after treatment were statistically significant Significance (all P <0.05). After treatment, the differences between the two groups were statistically significant (all P <0.05). Conclusion Octreotide acetate combined with esomeprazole in the treatment of cirrhosis esophageal variceal bleeding can improve vascular endothelial function and improve the success rate of hemostasis.