Objective To study the efficacy of Pantoprazole combined with somatostatin in the treatment of decompensated cirrhosis with esophageal-gastric fundus variceal bleeding and its influence on hemodynamics. Method 92 cases of decompensated cirrhosis patients with esophageal-gastric fundus variceal bleeding from January 2014 to October 2015 in NO.454 Hospital of PLA were collected and divided into research group and control group according to the random number table, 46 cases in each group. Research group patients received Pantoprazole combined with somatostatin therapy, control group patients received vasopressin therapy, the efficacy and hemodynamic changes of the two groups were compared. Result The hemostasis success rate and efficient of varicose veins of research group were significantly higher than that of control group (P<0.05);the re-bleeding rate of research group was significantly lower than that of control group (P < 0.05); the blood transfusion, bleeding time and hospital stay of research group were significantly less than those of control group (P < 0.05). After treatment, inside diameter of portal vein, splenic vein and left gastric vein were significantly smaller than that of before treatment (P < 0.05), blood flow of portal vein and splenic vein were significantly less than that of before treatment (P < 0.05), blood flow rate of portal vein and splenic vein were significantly slower than that of before treatment (P < 0.05), mean arterial pressure and central venous pressure were significantly higher than that of before treatment (P < 0.05), heart rate was lower than that of before treatment (P < 0.05), the changes of above indexes of research group were significantly higher than those of control group (P < 0.05). Conclusion Pantoprazole combined with somatostatin in the treatment of decompensated cirrhosis patients with esophageal-gastric fundus variceal bleeding is safe and effective, which improve the hemodynamic status and hemostasis, should be widely applied.%目的 观察泮托拉唑联合生长抑素治疗失代偿期肝硬化伴食管胃底静脉曲张破裂出血的疗效及其对血流动力学的影响.方法 选取2014年1月至2015年10月解放军第四五四医院收治的92例失代偿期肝硬化伴食管胃底静脉曲张破裂出血患者为研究对象,按照随机数表法将其分为研究组和对照组,每组各46例.研究组患者予以泮托拉唑联合生长抑素治疗,对照组患者予以垂体后叶素治疗,比较两组患者的疗效与血流动力学变化情况.结果 研究组患者止血成功率和静脉曲张治疗有效率均显著高于对照组(P<0.05),再出血率显著低于对照组(P<0.05),输血量少于对照组(P<0.05),止血时间和住院天数均显著短于对照组(P<0.05).治疗后,两组患者门静脉内径、脾静脉内径、胃左静脉内径均显著小于治疗前(P<0.05),门静脉血流量和脾静脉血流量均显著少于治疗前(P<0.05),门静脉血流速度和脾静脉血流速度均显著慢于治疗前(P<0.05),平均动脉压和中心静脉压均显著高于治疗前,心率显著低于治疗前(P<0.05),且研究组患者上述指标变化幅度均显著大于对照组(P<0.05).结论 泮托拉唑联合生长抑素治疗失代偿期肝硬化伴食管胃底静脉曲张破裂出血,能够改善患者的血流动力学状态,提高止血效果,安全有效,值得推广应用.
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