生长抑素联合奥美拉唑治疗肝硬化并食管胃底静脉曲张破裂出血29例

目的观察生长抑素联合注射用奥美拉唑钠治疗肝硬化并食管胃底静脉曲张破裂出血的临床疗效和安全性。方法选择2007年至2010年收治的肝硬化并食管胃底静脉曲张破裂出血患者58例,按照入院日期分为2组,单日为观察组,双日为对照组,每组各29例。观察组给予生长抑素100μg静脉注射,继而以25μg/h持续静脉滴注24～48 h,洛赛克40 mg静脉注射,2次/d;对照组给予垂体后叶素首剂10 U,继而给予0.2～0.4 U/min持续静脉滴注12～24 h,总剂量30 U,在此基础上给予硝酸甘油10 mg+5%葡萄糖500 mL静脉滴注,10～20μg/min,治疗2 d。比较两组止血效果、不良反应发生情况等。结果治疗后,观察组平均止血时间为(13.8±2.2)h,显著低于对照组(P<0.05),观察组止血总有效率为96.55%,显著高于对照组的79.31%(P<0.05),两组均无严重不良反应发生。结论生长抑素联合注射用奥美拉唑钠治疗肝硬化并食管胃底静脉曲张破裂出血效果显著、快速、安全,适用于肝硬化并食管胃底静脉曲张破裂出血的药物治疗,值得临床推广。

Somatostatin Combined with Losec in Treating Liver Cirrhosis and Esophago-Gastric Fundus Variceal Bleedings in 29 Cases

Objective To study the clinical efficacy of somatostatin combined with losec in treating liver cirrhosis and esophago-gastric fundus variceal bleedings.Methods Fifty-eight patients with liver cirrhosis and esophago-gastric fundus variceal bleedings were selected and divided into two groups,patients in observation group were given intravenous somatostatin 100 μg and then continuous infusion 25 μg/h for 24-48 h,intravenous losec 40 mg,2 times/d;others in control group were given pituitrin 10 U for first dose,then continuous infusion 0.2-0.4 U/min for 12-24 h and total dose of 30 U,and intravenous infusion 10 mg nitroglycerin and 5%glucose.Hemostatic effect and bad reaction were compared after treatment.Results The average hemostatic time and total efficiency of observation group were 13.8±2.2 h and 96.6%respectively,and significantly difference than control group（P〈0.05）.Conclusion The method of omatostatin combined with losec in treating liver cirrhosis and esophago-gastric fundus variceal bleedings has a good effect and security,and deserved to clinical.