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目的探讨生长抑素联合特利加压素作用于肝硬化急性食管胃底静脉曲张破裂出血的临床效果。方法 50例肝硬化急性食管胃底静脉曲张破裂出血患者,随机分为观察组(26例)和对照组(24例)。对照组给予生长抑素治疗,观察组给予生长抑素联合特利加压素治疗。比较两组临床效果。结果观察组止血时间为(6.1±2.4)h,短于对照组的(8.3±2.8)h,差异有统计学意义(t=2.9900,P=0.0044<0.05)。观察组输血量为(3.8±2.0)U,少于对照组的(5.7±2.4)U,差异有统计学意义(t=3.0499,P=0.0037<0.05)。观察组再出血率为11.54%(3/26),低于对照组的37.50%(9/24),差异有统计学意义(χ~2=4.6116 P=0.0137<0.05)。观察组死亡率为7.69%(2/26),低于对照组的29.17%(7/24),差异有统计学意义(χ~2=3.8891,P=0.0037<0.05)。观察组在治疗中出现腹泻1例,不良反应发生率为3.85%;对照组在治疗中出现腹部痉挛性疼痛1例,不良反应发生率为4.17%;两组不良反应发生率比较差异无统计学意义(χ~2=0.0033,P=0.9081>0.05),两组患者未经处理不良反应均自动消失,未对治疗产生负面影响。结论在肝硬化急性食管胃底静脉曲张破裂出血的治疗中,采用生长抑素联合特利加压素治疗整体效果良好,值得在临床实践中予以借鉴并推广。
Objective To investigate the clinical effect of somatostatin combined with terlipressin on acute esophageal variceal bleeding in patients with liver cirrhosis. Methods Fifty patients with acute esophagogastric variceal bleeding of liver cirrhosis were randomly divided into observation group (26 cases) and control group (24 cases). The control group was given somatostatin treatment, the observation group was given somatostatin combined with terlipressin treatment. The clinical effects of two groups were compared. Results The bleeding time in the observation group was (6.1 ± 2.4) h, shorter than that in the control group (8.3 ± 2.8) h, the difference was statistically significant (t = 2.9900, P = 0.0044 <0.05). The blood transfusion in the observation group was (3.8 ± 2.0) U less than that in the control group (5.7 ± 2.4) U, the difference was statistically significant (t = 3.0499, P = 0.0037 <0.05). The rebleeding rate in the observation group was 11.54% (3/26), which was lower than that in the control group (37.50%, 9/24). The difference was statistically significant (χ ~ 2 = 4.6116 P = 0.0137 <0.05). The mortality in the observation group was 7.69% (2/26), which was lower than that in the control group (29.17%, 7/24). The difference was statistically significant (χ ~ 2 = 3.8891, P = 0.0037 <0.05). One case of diarrhea and 3.85% of adverse reactions occurred in the observation group. One case of abdominal spastic pain in the control group and 4.17% of adverse reactions occurred in the observation group. There was no significant difference in the incidence of adverse reactions between the two groups Significance (χ ~ 2 = 0.0033, P = 0.9081> 0.05), untreated adverse reactions were automatically disappeared in both groups, did not have a negative impact on treatment. Conclusion In the treatment of acute esophagogastric variceal bleeding due to cirrhosis, the combination of somatostatin and terlipressin has a good overall effect, which is worthy of reference and promotion in clinical practice.