酚磺乙胺联合奥曲肽治疗肝硬化上消化道出血的临床研究

目的探究酚磺乙胺注射液联合醋酸奥曲肽注射液治疗肝硬化上消化道出血的临床疗效。方法选取2011年3月—2016年6月中国人民解放军白求恩国际和平医院二五六临床部消化内科收治的肝硬化上消化道出血患者64例作为研究对象,在随机分组的原则下将所有患者分为对照组和治疗组,每组各32例。对照组静脉滴注醋酸奥曲肽注射液,0.1 mg加入到0.9%氯化钠溶液250 m L中,滴注速度0.025 mg/h,1次/d。治疗组在对照组基础上静脉滴注酚磺乙胺注射液,0.5 g加入5%葡萄糖注射液250 m L中,2次/d。两组患者均连续治疗4 d。观察两组的临床疗效,比较两组的临床指标、肝纤维化指标和门静脉血流量(PVF)。结果治疗后,对照组和治疗组的总有效率分别为75.00%、96.88%,两组比较差异有统计学意义(P0.05)。治疗后,治疗组止血时间、住院时间和输血量均明显低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,两组人Ⅲ型前胶原(PCⅢ)、层粘连蛋白(LN)、PVF均显著性降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗组这些观察指标明显低于对照组,两组比较差异具有统计学意义(P0.05)。结论酚磺乙胺注射液联合醋酸奥曲肽注射液治疗肝硬化上消化道出血具有较好的临床疗效,可改善肝纤维化,缩短止血时间和住院时间,减少输血量,降低门静脉压力,安全性较好,具有一定的临床推广应用价值。

Clinical study on etamsylate combined with octreotide in treatment of cirrhosis complicated with upper gastrointestinal hemorrhage

Objective To investigate the clinical effect of Etamsylate Injection combined with Octreotide Acetate Injection in treatment of cirrhosis complicated with upper gastrointestinal hemorrhage.Methods Patients (64 cases) with cirrhosis complicated with upper gastrointestinal hemorrhage in Department of Gastroenterology of 256 Clinical Department of Bethune International Peace Hospital of People's Liberation Army from March 2011 to June 2016 were randomly divided into control and treatment groups, and each group had 32 cases. Patients in the control group were iv administered with Octreotide Acetate Injection, 0.1 mg added into 250mL normal saline, infusion speed of 0.025 mg/h, once daily. Patients in the treatment group were iv administered with Etamsylate Injection on the basis of the control group, 0.5 g added into 5％ glucose solution 250 mL, twice daily. Patients in two groups were treated for 4 d. After treatment, the clinical efficacies were evaluated, and clinical indexes, liver fibrosis, and PVF in two groups were compared.Results After treatment, the clinical efficacies in the control and treatment groups were 75.00％ and 96.88％, respectively, and there was difference between two groups (P < 0.05). After treatment, hemostasis time, hospitalization time, and blood transfusion volume in the treatment group were significantly shorter than those in the group, and there was difference between two groups (P < 0.05). After treatment, PCⅢ, LN, and PVF in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P<0.05).Conclusion Etamsylate Injection combined with Octreotide Acetate Injection has clinical curative effect in treatment of cirrhosis complicated with upper gastrointestinal hemorrhage, can improve liver fibrosis, shorten hemostasis time and hospitalization time, decrease portal pressure, with good safety, which has a certain clinical application value.