肝硬化合并上消化道出血患者应用普萘洛尔联合奥曲肽治疗的效果观察

目的观察肝硬化合并上消化道出血患者应用普萘洛尔联合奥曲肽治疗的效果。方法60例肝硬化合并上消化出血患者,通过计算机数字随机分配原则分为对照组与观察组,每组30例。对照组患者应用奥曲肽治疗,观察组患者则应用普萘洛尔联合奥曲肽治疗。比较两组临床效果、治疗前后血流动力学指标变化、不良反应发生率及止血时间。结果观察组治疗总有效率为96.7%,高于对照组的76.7%,差异有统计学意义(P<0.05)。治疗后,两组门静脉内径、脾静脉内径、门静脉血流量、脾静脉血流量均低于治疗前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。观察组不良反应发生率为6.7%,与对照组的3.3%比较,差异无统计学意义(P>0.05)。观察组消化道止血时间(15.0±3.4)h短于对照组的(22.3±4.6)h,差异有统计学意义(P<0.05)。结论将奥曲肽与普萘洛尔联合用于肝硬化合并上消化道出血的临床治疗中,其效果显著,能明显改善患者血流动力学,消除不良症状,值得在推广应用。

Observation of the effect of propranolol combined with octreotide in patients with liver cirrhosis and upper gastrointestinal hemorrhage

Objective To observe the effect of propranolol combined with octreotide in patients with liver cirrhosis and upper gastrointestinal hemorrhage.Methods A total of 60 patients with liver cirrhosis and upper gastrointestinal hemorrhage were randomly divided into control group and observation group,with 30 cases in each group.The control group was treated with octreotide,and the observation group was treated with propranolol combined with octreotide.The clinical effect,hemodynamic indexes before and after treatment,incidence of adverse reactions and hemostasis time were compared between the two groups.Results The total treatment effective rate of the observation group was 96.7%,which was higher than 76.7%of the control group,and the difference was statistically significant(P<0.05).After treatment,the portal vein diameter,splenic vein diameter,portal vein blood flow,splenic vein blood flow of the two groups were lower than those before treatment,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05).The incidence of adverse reactions of the observation group was 6.7%,which had no statistically significant difference compared with 3.3%of the control group(P>0.05).The hemostasis time of digestive tract(15.0±3.4)h of the observation group was shorter than(22.3±4.6)h of the control group,and the difference was statistically significant(P<0.05).Conclusion The combination of octreotide and propranolol has a significant effect in the clinical treatment of liver cirrhosis combined with upper gastrointestinal hemorrhage,which can significantly improve the hemodynamics of patients and eliminate adverse symptoms.It is worthy of promotion and application.