摘要
目的:研究奥美拉唑与垂体后叶素联合应用对肝硬化合并上消化道出血(UGIB)患者疗效、血液流变学和血管活性因子的影响。方法:选取我院2018年1月至2019年1月收治的106例肝硬化合并UGIB患者,按随机表法分为两组,每组53例。对照组患者采用奥美拉唑联合生长抑素治疗,研究组患者采用奥美拉唑联合垂体后叶素治疗。比较两组患者疗效、血液流变学和血管活性因子的变化,统计治疗期间不良反应发生率。结果:研究组患者止血时间及住院时间均较对照组短,研究组患者输血量较对照组明显减少,差异均有统计学意义(P<0.05)。治疗后两组患者肝静脉压力梯度、EF、NO水平、GBS评分均较治疗前明显降低,且研究组降低更明显(均P<0.05)。治疗后两组患者血红蛋白、全血高切黏度、全血低切黏度、血浆黏度均较治疗前上升,且研究组上升更明显(P<0.05)。对照组再出血率为15.1%(8/53),研究组为3.8%(2/53),差异有统计学意义(P<0.05)。对照组患者总有效率为79.2%,研究组为94.3%,差异有统计学意义(P<0.05)。比较两组患者恶心呕吐、腹痛、血压升高、头晕头痛、皮疹等不良反应,差异无统计学意义(P>0.05)。结论:奥美拉唑与垂体后叶素联合应用治疗肝硬化合并UGIB能改善患者异常的血液流变学,降低ET-1和NO水平、明显降低门静脉压力、较快止血、减少输血量、减少再出血发生、缩短住院时间、降低重症患者比例,临床疗效更好。
Objective:To study the influence of pituitrin on the curative effect,hemorheology and vasoactive factor of liver cirrhosis complicated by upper gastrointestinal bleeding(UGIB).Methods:A total of 106 patients with cirrhosis complicated with UGIB in our hospital from January 2018 to January 2019 were selected and divided into the control group(n=53)and the study group(n=53)the random number table.The control group was treated with omeprazole combined with somatosatin,while the study group was treated with omeprazole combined with pituitrin.The changes of efficacy,hemorheology and vasoactive factors in the two groups were analyzed and compared,and the incidence of adverse reactions during treatment was counted.Results:The hemostasis time and hospitalization time in the study group were shorter than those in the control group,and the blood transfusion volume in the study group was significantly reduced compared with the control group,with statistically significant difference(P<0.05).After treatment,the hepatic venous pressure gradient in the two groups was significantly lower than that before treatment,and the reduction was more significant in the study group(P<0.05).After treatment,hemoglobin in both groups increased compared with that before treatment,and the increase was more significant in the study group(P<0.05).The total effective rate of the control group was 79.2%,and that of the study group was 94.3%.The clinical efficacy of the study group was better than that of the control group,and the difference was statistically significant(P<0.05).The rebleeding rate in the control group was 15.1%(8/53),while that in the study group was 3.8%(2/53),the difference was statistically significant(χ^(2)=3.97,P<0.05).After treatment,GBS score in both groups decreased compared with that before,and GBS score in the study group decreased significantly compared with the control group(P<0.05).After treatment,high whole blood viscosity,low whole blood viscosity and plasma viscosity of the two groups increased compared with that before treatment,and the increase was more obvious in the study group(P<0.05).After treatment,ET-1 and NO levels of patients in both groups decreased compared with those before,and the decrease was more significant in the study group(P<0.05).Nausea and vomiting,abdominal pain,elevated blood pressure,dizziness,headache,rash and other adverse reactions were compared between the two groups,and the differences were not statistically significant(P>0.05).Conclusion:Pituitary-assisted therapy for patients with cirrhosis complicated by UGIB can improve hemorheological abnormalities,reduce ET-1 and NO levels,significantly reduce portal venous pressure,stop bleeding faster,reduce blood transfusion volume,reduce rebleeding,shorten hospitalization time,and reduce the proportion of patients with severe disease,with better clinical efficacy.
作者
孟庆志
张月华
王海舰
郑艳龙
李建霞
MENG Qing-zhi;ZHANG Yue-hua;WANG Hai-jian(Langfang People′s Hospital,Hebei,Langfang,065000,China)
出处
《中西医结合肝病杂志》
CAS
2021年第11期990-993,共4页
Chinese Journal of Integrated Traditional and Western Medicine on Liver Diseases
基金
廊坊市科技支撑计划项目(No.2020013073)。
