生长抑素联合特利加压素治疗食管胃底静脉曲张破裂出血的疗效评价
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摘要
目的分析评价生长抑素联合特利加压素治疗食管胃底静脉曲张破裂出血的疗效。方法研究对象:方便2017年3月—2018年3月该院收治的62例食管胃底静脉曲张破裂出血患者;分组方法:根据患者就诊治疗先后顺序分为研究甲组和研究乙组两组,每组中患者例数均为31例;治疗方法:研究甲组患者采用生长抑素联合特利加压素治疗,观察乙组患者单纯采用生长抑素治疗;研究目的 :分析治疗疗效。结果治疗结束后,研究甲组中显效、有效的患者例数明显多于治疗乙组,其无效的患者例数明显少于治疗乙组患者,治疗总有效率93.54%高于治疗乙组患者的有效率77.42%;差异有统计学意义(χ2=4.100 5 P<0.05);研究甲组输血量(3.81±2.41)U低于研究乙组(5.97±2.68)U,差异有统计学意义(χ2=3.336 7,P<0.05);研究甲组止血率、再出血率、死亡率分别为:80.10%、9.68%、6.45%;研究乙组分别为:64.52%、29.03%、25.81%,差异有统计学意义(χ2=4.822 2,4.428 6,5.314 3,P=0.028 0,0.035 3,0.0211);研究甲组不良反应发生率为16.13%与研究乙组12.90%比较,差异无统计学意义(χ2=0.164 0,P>0.05)。结论对于食管胃底静脉曲张破裂出血患者,采用生长抑素联合特利加压素进行治疗,止血效果好,安全性能高,治疗后的疾病复发率低,因此在临床中应用价值较大。
Objective To evaluate the efficacy of somatostatin combined with terlipressin in the treatment of esophageal and gastric varices bleeding. Methods From March 2017 to March 2018, 62 patients with esophagogastric varices bleeding in our hospital were convenient treated. Grouping method: According to the order of treatment, the patients were divided into study group A and study group B. The number of patients in the group was 31 cases, treatment: patients in group A were treated with somatostatin plus terlipressin, patients in group B were treated with somatostatin alone. Objective: To analyze the therapeutic effect. Results After the treatment, the number of patients in the study group A was significantly more effective than that in the treatment group B. The number of patients who were ineffective was significantly less than that in the treatment group B. The total effective rate was 93.54% higher than that in the treatment group B of effective rate was77.42%. The difference was statistically significant(χ2=4.1005,P<0.05). The blood transfusion volume of group A(3.81±2.41)U was lower than that of group B(5.97±2.68) U. The difference was statistically significant(χ2=3.336 7,P<0.05). The hemostasis rate, rebleeding rate and mortality rate of group A were 80.10%, 9.68% and 6.45%, respectively. The groups were: 64.52%, 29.03%, 25.81%; the difference was statistically significant(χ2=4.822 2,4.428 6,5.314 3,P=0.028 0,0.035 3,0.021 1,P<0.05); The incidence of adverse reactions was 16.13% and the difference between study group 12.90% was not statistically significant(χ2=0.164 0,P>0.05). Conclusion For patients with esophageal varices bleeding, treatment with somatostatin combined with terlipressin has good hemostatic effect, high safety performance and low recurrence rate after treatment. Therefore, it has great value in clinical application.
Objective To evaluate the efficacy of somatostatin combined with terlipressin in the treatment of esophageal and gastric varices bleeding. Methods From March 2017 to March 2018, 62 patients with esophagogastric varices bleeding in our hospital were convenient treated. Grouping method: According to the order of treatment, the patients were divided into study group A and study group B. The number of patients in the group was 31 cases, treatment: patients in group A were treated with somatostatin plus terlipressin, patients in group B were treated with somatostatin alone. Objective: To analyze the therapeutic effect. Results After the treatment, the number of patients in the study group A was significantly more effective than that in the treatment group B. The number of patients who were ineffective was significantly less than that in the treatment group B. The total effective rate was 93.54% higher than that in the treatment group B of effective rate was77.42%. The difference was statistically significant(χ2=4.1005,P<0.05). The blood transfusion volume of group A(3.81±2.41)U was lower than that of group B(5.97±2.68) U. The difference was statistically significant(χ2=3.336 7,P<0.05). The hemostasis rate, rebleeding rate and mortality rate of group A were 80.10%, 9.68% and 6.45%, respectively. The groups were: 64.52%, 29.03%, 25.81%; the difference was statistically significant(χ2=4.822 2,4.428 6,5.314 3,P=0.028 0,0.035 3,0.021 1,P<0.05); The incidence of adverse reactions was 16.13% and the difference between study group 12.90% was not statistically significant(χ2=0.164 0,P>0.05). Conclusion For patients with esophageal varices bleeding, treatment with somatostatin combined with terlipressin has good hemostatic effect, high safety performance and low recurrence rate after treatment. Therefore, it has great value in clinical application.
引文
[1]王贵良,邱萍,徐林芳,等.生长抑素、特利加压素及奥曲肽治疗食管胃底静脉曲张破裂出血成本-效果分析[J].中国现代医生,2016,52(28):106-108,116.
[2] Júlio RPimenta,Alexandre R.Ferreira,Eleonora D.Factors Associated With Bleeding Secondary to Rupture of Esophageal Varices in Children and Adolescents With Cirrhosis[J].Journal of Pediatric Gastroenterology and Nutrition,2017,2(2):e44-e48.
[3]胡凤艳.生长抑素联合特利加压素治疗肝硬化急性食管胃底静脉曲张破裂出血患者的临床疗效[J].中国实用医药,2016,24(33):108-109.
[4] Changjun Men,Guoliang Zhang.Endoscopic ultrasonography predicts early esophageal variceal bleeding in liver cirrhosis:A case report[J].Medicine,2017,27(17):e6749.
[5]翟学敏.生长抑素联合特利加压素治疗肝硬化出血疗效观察[J].中国实用医刊,2016,41(5):62-63.
[6]范长生,吴久鸿.特利加压素注射液治疗食管胃静脉曲张出血成本-效用分析[J].中国药学杂志, 2017, 52(9):782-786.
[7]程艳洁.特利加压素、生长抑素、泮托拉唑联合治疗肝硬化食管胃底静脉曲张破裂出血临床疗效观察[J].海峡药学,2016,31(9):104-106.
[8]王琼,王景,邓菁,等.生长抑素和特利加压素单用或联用治疗肝硬化上消化道出血成本-效果分析[J].中国现代医生, 2015, 53(28):49-52.
[9]祝沛沛,彭雷,范才波,等.生长抑素对肝硬化食管胃底静脉曲张破裂出血患者胃肠激素及血流动力学的影响[J].疑难病杂志,2017,21(6):579-583.
[10]李佳婧,陈道荣.特利加压素与生长抑素治疗食管胃底静脉曲张出血的疗效meta分析[J].现代医药卫生,2016,20(2):170-172.
[11]阎国宝.国产与进口生长抑素治疗肝硬化食管胃底静脉曲张破裂出血效果对比[J].现代消化及介入诊疗, 2015,20(6):694-695.
[12]王军,彭浩.特利加压素联合生长抑素治疗肝硬化食管胃底静脉曲张破裂出血疗效观察[J].实用肝脏病杂志,2015,2(4):418-419.
[2] Júlio RPimenta,Alexandre R.Ferreira,Eleonora D.Factors Associated With Bleeding Secondary to Rupture of Esophageal Varices in Children and Adolescents With Cirrhosis[J].Journal of Pediatric Gastroenterology and Nutrition,2017,2(2):e44-e48.
[3]胡凤艳.生长抑素联合特利加压素治疗肝硬化急性食管胃底静脉曲张破裂出血患者的临床疗效[J].中国实用医药,2016,24(33):108-109.
[4] Changjun Men,Guoliang Zhang.Endoscopic ultrasonography predicts early esophageal variceal bleeding in liver cirrhosis:A case report[J].Medicine,2017,27(17):e6749.
[5]翟学敏.生长抑素联合特利加压素治疗肝硬化出血疗效观察[J].中国实用医刊,2016,41(5):62-63.
[6]范长生,吴久鸿.特利加压素注射液治疗食管胃静脉曲张出血成本-效用分析[J].中国药学杂志, 2017, 52(9):782-786.
[7]程艳洁.特利加压素、生长抑素、泮托拉唑联合治疗肝硬化食管胃底静脉曲张破裂出血临床疗效观察[J].海峡药学,2016,31(9):104-106.
[8]王琼,王景,邓菁,等.生长抑素和特利加压素单用或联用治疗肝硬化上消化道出血成本-效果分析[J].中国现代医生, 2015, 53(28):49-52.
[9]祝沛沛,彭雷,范才波,等.生长抑素对肝硬化食管胃底静脉曲张破裂出血患者胃肠激素及血流动力学的影响[J].疑难病杂志,2017,21(6):579-583.
[10]李佳婧,陈道荣.特利加压素与生长抑素治疗食管胃底静脉曲张出血的疗效meta分析[J].现代医药卫生,2016,20(2):170-172.
[11]阎国宝.国产与进口生长抑素治疗肝硬化食管胃底静脉曲张破裂出血效果对比[J].现代消化及介入诊疗, 2015,20(6):694-695.
[12]王军,彭浩.特利加压素联合生长抑素治疗肝硬化食管胃底静脉曲张破裂出血疗效观察[J].实用肝脏病杂志,2015,2(4):418-419.