目的 探讨注射用特利加压素联合注射用奥美拉唑治疗肝硬化上消化道出血的临床疗效。方法 选取2015年3月—2017年3月在平煤神马医疗集团总医院进行治疗的肝硬化上消化道出血患者82例为研究对象，根据用药的差别将入组者分为对照组和治疗组，每组各41例。对照组静脉滴注注射用奥美拉唑钠，40 mg加入到0.9%氯化钠溶液100 mL中，2次/d，出血控制后再治疗2 d。治疗组在对照组基础上静脉推注注射用特利加压素，首次剂量为2 mg，注射时间>1 min，维持剂量1～2 mg/4 h，持续24～48 h，直至出血控制，然后再治疗2 d。观察两组的临床疗效，比较两组的生活质量量表（QLQ-C30）评分、血流动力学指标、血清学指标、止血时间、输血量、游离肝静脉压（FHVP）和肝静脉楔嵌压（WHVP）。结果 治疗后，对照组和治疗组的总有效率分别为80.49%、95.12%，两组比较差异有统计学意义（P<0.05）。治疗后，两组躯体、认知、角色、社会功能评分均明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些指标明显高于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组门静脉血流、脾静脉血流、门静脉内径、脾静脉内径均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些指标明显低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组血清超敏C反应蛋白（hs-CRP）、皮质醇、胰高血糖素、一氧化氮（NO）水平均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些指标明显低于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，治疗组平均止血时间、平均输血量均少于对照组，两组比较差异具有统计学意义（P<0.05）。治疗后，两组FHVP、WHVP均明显降低，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗组这些指标明显低于对照组，两组比较差异具有统计学意义（P<0.05）。结论 注射用特利加压素联合注射用奥美拉唑治疗肝硬化上消化道出血具有较好的临床疗效，可改善机体血流动力学指标，降低血清hs-CRP、皮质醇、胰高血糖素、NO水平，提高患者生活质量，具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Terlipressin for injection combined with Omeprazole Sodium for injection in treatment of liver cirrhosis with upper gastrointestinal bleeding. Methods Patients (82 cases) with liver cirrhosis with upper gastrointestinal bleeding in Pingdingshan Shenma Medical Group General Hospital from March 2015 to March 2017 were enrolled in this study. According to the difference treatment plan, patients were divided into control and treatment groups, and each group had 41 cases. Patients in the control group were iv administered with Omeprazole Sodium for injection, 40 mg added into normal saline 100 mL, twice daily, retreatment of 2 d after bleeding control. Patients in the treatment group were iv administered with Terlipressin for injection on the basis of the control group, first dose of 2 mg, injection time > 1 min, maintenance dose of 1-2 mg/4 h, continuous treatment of 24-48 h, until bleeding control, then retreatment of 2 d. After treatment, the clinical efficacies were evaluated, and QLQ-C30 scores, hemodynamic indexes, serological indexes, hemostasis time, blood transfusion volume, free hepatic venous pressure (FHVP), and hepatic vein wedge pressure (WHVP) in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.49% and 95.12%, respectively, and there was difference between two groups (P < 0.05). After treatment, the scores of body, cognition, role, and social function in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P < 0.05). After treatment, portal vein blood flow, splenic vein blood flow, portal vein diameter, and splenic vein diameter 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). After treatment, the levels of hs-CRP, cortisol, glucagon, and NO 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). After treatment, the average hemostasis time and average blood transfusion volume in the treatment group were significantly less than those in the control group, and there was difference between two groups (P < 0.05). After treatment, FHVP and WHVP 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 Terlipressin for injection combined with Omeprazole Sodium for injection has clinical curative effect in treatment of liver cirrhosis with upper gastrointestinal bleeding, can improve the hemodynamics indexes, reduce the levels of serum hs-CRP, cortisol, pancreatic glucagon, and NO, improve the quality of life, which has a certain clinical application value.