奥曲肽联合特利加压素治疗肝硬化食管静脉破裂出血疗效观察

来源 :中国煤炭工业医学杂志 | 被引量 : 0次 | 上传用户:kisscase
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目的观察奥曲肽联合特利加压素在治疗肝硬化食管静脉破裂出血患者的疗效。方法将该院肝硬化食管静脉曲张破裂出血患者94例随机分内奥曲肽组和联合治疗组,所有患者先应用奥曲肽(首剂静脉推注0.1mg,然后给予0.9%Nacl 50ml+奥曲肽0.6mg持续q12h静脉泵入),如24h后出血未停止,再随机分为二组,联合治疗组加上特利加压素(首剂静脉2mg后,间隔4h静脉注射1mg),奥曲肽组加快给药速度(0.9%Nacl 50ml+奥曲肽0.6mgq8h持续静脉泵入),二组给药时间维持48~72h,观察二组出血停止时间,再出血率,病死率和不良反应。结果联合治疗组临床疗效高于奥曲肽组(P<0.05),联合治疗组不良反应有血压升高及心悸等,奥曲肽组不良反应有心率减慢,腹部痉挛性疼痛,均在减少用药量后缓解。结论奥曲肽联合特利加压素治疗肝硬化食管静脉曲张破裂出血疗效优于单用奥曲肽,且安全性好,但费用较高。 Objective To observe the efficacy of octreotide combined with terlipressin in the treatment of patients with esophageal variceal bleeding due to cirrhosis. Methods Ninety-four patients with cirrhosis esophageal variceal bleeding were randomized to receive octreotide and combination therapy. All patients were given octreotide (the first bolus of 0.1 mg, followed by 0.9% Nacl 50ml + octreotide 0.6mg for q12h (Such as intravenous injection of intravenous injection of 2mg intravenous 2mg after the first intravenous injection), octreotide group to accelerate the drug delivery rate (0.9 % Nacl 50ml + octreotide 0.6mgq8h continuous intravenous infusion), the two groups were administered for 48 ~ 72h, the bleeding stop time, rebleeding rate, mortality and adverse reactions were observed in the two groups. Results The clinical efficacy of combination therapy group was higher than that of octreotide group (P <0.05). The side effects of combination therapy group were high blood pressure and palpitations. The adverse reactions of octreotide group were heart rate slowed down and abdominal crampy pain were relieved after decreasing dosage . Conclusion The efficacy of octreotide combined with terlipressin in treating cirrhosis and esophageal variceal bleeding is superior to that of octreotide alone, and it is safe and costly.
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