奥曲肽与垂体后叶素疗法结合Rockall危险性积分在治疗急性食管胃底静脉曲张破裂出血的临床应用分析

【目的】利用Rockall危险性积分对临床奥曲肽联合垂体后叶素疗法治疗急性食道胃底静脉曲张破裂出血的疗效与安全性进行分析。【方法】对本院收治的108例肝硬化食管胃底静脉曲张破裂出血的患者按照治疗模式分为两组，其中单用奥曲肽治疗组57例，联合奥曲肽与垂体后叶素治疗组51例。利用Rockall危险性积分对奥曲肽治疗组以及联合用药组患者分别进行评分，并分为低危险组（0～3）、中危组（4～7）、高危组（≥8），并就两种疗法对低、中、高组患者疗效的临床指标进行比较分析。【结果】低Rockall危险等级，奥曲肽治疗组与奥曲肽联合垂体后叶素治疗组平均止血时间、止血率、再出血率差异无显著性（P〉0．05）。在中、高Rockall危险等级，联合治疗组将平均止血时间由（27．1±10．4）h、（30．3±9．8）h分别降低至（23．5±9．2）h、（25．7±8．5）h，差异有显著性（P〈0．05）。止血率以及再出血率在中、高危险等级的患者中，联合疗法也呈现较好的治疗效果。【结论】奥曲肽联合垂体后叶素的治疗模式，能够有效的控制食管胃底静脉曲张破裂引起的出血，该疗法针对危重患者尤其值得推荐。

Application of Octreotide and Hypophysin Combined with Rockall Risk Score in the Treatment of Esophageal Variceal Bleeding

Objective] To explore the efficacy and safety of octreotide and hypophysin for the treatment of patients with acute esophageal variceal bleeding via Rockall risk score. Methods]A total of 108 patients with liver cirrhosis and esophageal variceal bleeding were divided into two groups. The 57 patients were treated with octreotide alone and 51 patients were treated with octreotide and hypophysin together. All the patients were divided into three grades via different Rockall risk score. Low grade was scored 0-3, middle grade was scored 4 -7 and high grade was scored more than 8. The efficacy and safety of the two treatment methods were compared between the two groups in three grades. Results]No significant difference was found between the two groups in the low grade. In the middle and high grade, the combined therapy significantly decreased the average hemostasis time from 27.1±10.4h to 23.5±9.2h in middle grade and from 30.3±9.8 h to 25.7±8.5 h in high grade （ P 〈0.05）. The combined therapy represented higher hemostasis rate and decreased recurrent bleeding rate. Conclusion] The combined therapy of octreotide and hypophysin can treat acute esophageal variceal bleeding effectively and safely for the advanced patients especially.