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目的评价不同剂量奥曲肽联合兰索拉唑治疗肝硬化合并上消化道出血疗效及安全性。方法 2013年5月—2016年5月收治的80例肝硬化合并上消化道出血患者均予奥曲肽联合兰索拉唑治疗,根据奥曲肽的剂量不同分为大剂量组(40例)与小剂量组(40例),治疗前后分别彩超测定门静脉平均流速(PVV)与门静脉内径(PVD),记录止血时间、输血例数、输血量及再出血例数,观察不良反应。结果治疗后2组PVV与PVD均明显改善(P<0.05),组间比较无明显差异。大剂量组止血时间、输血率、输血量及再出血率均明显少于小剂量组(P<0.05)。大剂量组总有效率为90.0%,小剂量组为70.0%,两组比较差异显著(P<0.05)。大剂量组不良反应发生率与小剂量组无明显差异。结论大剂量奥曲肽联合兰索拉唑治疗肝硬化合并上消化道出血对止血作用有增益,且不会明显增加不良反应。
Objective To evaluate the efficacy and safety of different doses of octreotide combined with lansoprazole in the treatment of liver cirrhosis complicated with upper gastrointestinal bleeding. Methods Eighty patients with cirrhosis complicated with upper gastrointestinal bleeding admitted to our hospital from May 2013 to May 2016 were treated with octreotide combined with lansoprazole. According to the dose of octreotide, the patients were divided into high dose group (40 cases) and low dose group (40 cases). Before and after treatment, the average PVP and PVP were measured by color Doppler ultrasonography. The hemostatic time, the number of blood transfusion, the amount of blood transfusion and the number of rebleeding were recorded to observe the adverse reactions. Results After treatment, the PVV and PVD in both groups were significantly improved (P <0.05), no significant difference between the two groups. The bleeding time, transfusion rate, transfusion volume and rebleeding rate of high-dose group were significantly less than those of low-dose group (P <0.05). The total effective rate was 90.0% in the high-dose group and 70.0% in the low-dose group, with significant difference between the two groups (P <0.05). There was no significant difference in the incidence of adverse reactions between high-dose group and low-dose group. Conclusion High dose of octreotide combined with lansoprazole in the treatment of liver cirrhosis complicated with upper gastrointestinal bleeding has a hemostatic effect with a gain, and does not significantly increase adverse reactions.