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目的比较3组方案治疗肝硬化上消化道出血(UGH)的临床疗效及安全性。方法将146例肝硬化上消化道出血患者在常规治疗基础上随机分为3组,分别使用不同的治疗方案。Ⅰ组(52例)以生长抑素0.25mg静注后,继之0.25mg/h持续点滴;Ⅱ组(49例)以垂体后叶素10u静注后,继以0.2～0.4u/min加硝酸甘油20～50μg/min持续静滴;Ⅲ组(45例)以垂体后叶素10u静注后,继以0.2～0.4u/min持续静滴。止血后剂量减半,继续用药48h,比较其临床疗效及不良反应。结果Ⅰ、Ⅱ组止血时间均短于Ⅲ组(P<0.05,P<0.01)。Ⅰ、Ⅱ组间差异也有统计学意义(P<0.05);Ⅰ、Ⅱ、Ⅲ组显效率分别为48.1%、38.8%和26.7%,总有效率分别为82.7%、69.4%和51.1%,Ⅰ组显效率高于Ⅲ组(P<0.05),Ⅰ、Ⅱ组总有效率均高于Ⅲ组(P<0.05,P<0.01),Ⅰ、Ⅱ组间显效率和总有效率差异均无统计学意义(P>0.05)。Ⅲ组不良反应均高于Ⅰ、Ⅱ组,Ⅰ、Ⅱ组间差异无统计学意义(P>0.05)。结论Ⅰ、Ⅱ组方案治疗肝硬化UGH有良好的疗效和安全性,可根据患者具体情况灵活选用。
Objective To compare the clinical efficacy and safety of three regimens in the treatment of cirrhosis with upper gastrointestinal hemorrhage (UGH). Methods A total of 146 patients with cirrhosis and upper gastrointestinal bleeding were randomly divided into 3 groups according to the conventional treatment, and different treatment regimens were used. In group Ⅰ (n = 52), intravenous infusion of 0.25 mg / h of somatostatin followed by intravenous injection of 0.25 mg / h of somatostatin, while in group Ⅱ (n = 49) Nitroglycerin 20 ~ 50μg / min continuous intravenous infusion; Ⅲ group (45 cases) pituitrin 10u intravenous infusion, followed by 0.2 ~ 0.4u / min continuous intravenous infusion. Hemostatic dose halved, continue to medication 48h, compare its clinical efficacy and adverse reactions. Results The bleeding time in groups Ⅰ and Ⅱ was shorter than that in group Ⅲ (P <0.05, P <0.01). The effective rates of group Ⅰ, Ⅱ and Ⅲ were 48.1%, 38.8% and 26.7% respectively, the total effective rates were 82.7%, 69.4% and 51.1%, respectively The total effective rate of group Ⅰ and group Ⅱ was higher than that of group Ⅲ (P <0.05, P <0.01), and there was no statistical difference between group Ⅰ and group Ⅱ Significance (P> 0.05). The adverse reactions in group Ⅲ were higher than those in group Ⅰ and Ⅱ, and there was no significant difference between groups Ⅰ and Ⅱ (P> 0.05). Conclusion Ⅰ, Ⅱ group of programs for the treatment of cirrhosis UGH have good efficacy and safety, according to the specific circumstances of patients with flexible choice.