生长抑素联合特利加压素治疗肝硬化急性食管静脉曲张破裂出血患者的临床观察

目的:观察生长抑素联合特利加压素治疗肝硬化急性食管静脉曲张破裂出血患者的临床疗效。方法:将我院住院肝硬化急性食管静脉曲张破裂出血患者83例随机分为联合治疗组与生长抑素组。联合治疗组41例应用生长抑素(首剂静脉注射250μg后,250μg.h-1静脉持续泵入)+特利加压素(首剂静脉注射2mg后,间隔4h静脉注射1mg)治疗;生长抑素组42例单用生长抑素(首剂静脉注射250μg后,250μg.h-1静脉持续泵入)。2组给药时间维持24～48h。观察2组临床疗效、止血时间、输血量再出血率、死亡率和不良反应。结果:治疗后,联合治疗组临床疗效显著高于生长抑素组(P<0.05);止血时间、输血量、再出血率及死亡率显著低于生长抑素组(P<0.05)。联合治疗组不良反应发生率为4.88%,生长抑素组未见明显不良反应,2组比较差异无统计学意义(P>0.05)。结论:生长抑素联合特利加压素治疗肝硬化急性食管静脉曲张破裂出血的疗效优于单用生长抑素,且安全性较好。

Clinical Observation of Somatostatin Combined with Terlipressin for Acute Esophageal Variceal Bleeding in Cirrhosis Patients

OBJECTIVE： To observe the clinical efficacy of somatostatin and terlipressin for acute esophageal variceal bleeding in cirrhotic patients. METHODS： 83 patients with acute esophageal variceal bleeding were randomized into combined treatment group and somatostatin group. 41 cases were given intravenous injection of somatostatin 250 μg and then continuous infusion of 250 μg h-1; and intravenous injection of terlipressin 2 mg by 1 mg after 4 h. 42 cases were given somatostatin alone with above method. The time of injection was 24-48 h in both group. Clinical efficacy, hemostasis duration, the incidence of rehaemorrhagia, mor- tality and adverse drug reaction were compared between 2 groups. RESULTS： Clinical efficacy was higher in combined treatment group than in somatostatin group （P〈0.05）. Time of hemostasis, volume of blood transfusion, the incidence of rehaemorrhagia and mortality were lower in combined treatment group than in somatostatin group （P〈0.05）. The incidence of ADR was 4.88% in combined treatment group, and there were no obvious side effects in somatostatin group（P〉0.05）, but there was no significant differences between 2 groups. CONCLUSION： Clinical efficacy of somatostatin combined with terlipressin is better than somatostatin alone in the treatment of acute esophageal variceal bleeding. There are few side effects.