目的 探讨奥曲肽联合普萘洛尔治疗肝硬化食管胃底静脉曲张破裂后出血的临床效果。方法 选择2010年1月—2014年5月在安康市中心医院诊治的肝硬化食管胃底静脉曲张破裂后出血患者200例,根据随机数字表法分为治疗组和对照组各100例。对照组口服普萘洛尔治疗,治疗组在对照组治疗的基础上给予奥曲肽注射液治疗,治疗观察周期为7 d。观察两组的止血时间和输血量,监测丙氨酸氨基转移酶(ALT)和天门冬氨酸氨基转移酶(AST)的变化。治疗结束后随访1年,比较患者的中位生存时间和1年生存率。结果 治疗组的止血时间与输血量分别为(21.56±3.12)h和(243.59±45.33)mL,明显少于对照组的(80.24±5.33)h和(529.45±92.45)mL(P<0.05)。两组治疗后血清ALT与AST水平都明显降低(P<0.05),同时治疗后治疗组的ALT与AST水平也明显低于对照组(P<0.05)。随访至2015年5月,治疗组的中位生存时间与1年生存率分别为(47.44±6.44)个月与97.0%,而对照组分别为(34.98±5.29)个月与89.0%,治疗组比对照组要更优(P<0.05)。结论 奥曲肽联合普萘洛尔治疗肝硬化食管胃底静脉曲张破裂后出血能发挥更好的止血效果,可促进肝功能的恢复,延长患者的生存时间,有很好的应用价值。
Objective To investigate the clinical effects of octreotide and propranolol for treating cirrhosis combined esophageal varices bleeding. Methods From January 2010 to May 2014, 200 cases of cirrhosis combined esophageal varices bleeding in Ankang City Central Hospital were selected, accorded to the random number table were equally divided into treatment group and control group, the patients in control group were given the oral propranolol therapy, and the patients in treatment group received octreotide and propranolol treatment on the basis of the control group, the treatment observation period was 7 d. Results The bleeding time and blood transfusion volume in the treatment group were (21.56 ± 3.12) h and (243.59 ± 45.33) mL that were significantly less than the control group of (80.24 ± 5.33) h and (529.45 ± 92.45) mL (P < 0.05). After treatment, the concentration of serum alanine aminotransferase and aspartate aminotransferase was significantly lower (P < 0.05), while the concentration of alanine aminotransferase and aspartate aminotransferase in the treatment group after treatment was significantly lower than that of the control group (P <0.05). Followed-up to May 2015, the median survival time and 1-year survival rates in the treatment group were (47.44 ± 6.44) months and 97.0%, while those in the control group were (34.98 ± 5.29) months and 89.0%, and those in the treatment group were better than control group (P <0.05). Conclusion The octreotide and propranolol for treating cirrhosis combined esophageal varices bleeding have better hemostatic effect, and they can promote the recovery of liver function and prolong survival time of patients, which has a good application value.