不同剂量奥曲肽联合兰索拉唑治疗肝硬化合并上消化道出血疗效及安全性评价

摘要

目的 评价不同剂量奥曲肽联合兰索拉唑治疗肝硬化合并上消化道出血疗效及安全性.方法 2013年5月-2016年5月收治的80例肝硬化合并上消化道出血患者均予奥曲肽联合兰索拉唑治疗,根据奥曲肽的剂量不同分为大剂量组(40例)与小剂量组(40例),治疗前后分别彩超测定门静脉平均流速(PW)与门静脉内径(PVD),记录止血时间、输血例数、输血量及再出血例数,观察不良反应.结果 治疗后2组PVV与PVD均明显改善(P＜0.05),组间比较无明显差异.大剂量组止血时间、输血率、输血量及再出血率均明显少于小剂量组(P＜0.05).大剂量组总有效率为90.0％,小剂量组为70.0％,两组比较差异显著(P＜0.05).大剂量组不良反应发生率与小剂量组无明显差异.结论 大剂量奥曲肽联合兰索拉唑治疗肝硬化合并上消化道出血对止血作用有增益,且不会明显增加不良反应.%Objective To evaluate the efficacy and safety of different doses Octreotide combined with Lansoprazole in the treatment of hepatocirrhosis with upper gastrointestinal bleeding.Methods Eighty hepatocirrhosis patients with upper gastrointestinal bleeding during May.2013 to May.2016 were treated with Octreotide combined with Lansoprazole,and were divided into high dose group (40 cases) and low dose group (40 cases) according to different doses Octreotide.Before and after treatment,portalvenousmaximumvelocity (PVV) and portalveindiameter (PVD) were detected by color Doppler ultrasound respectively,and haemostatic time,blood transfusion cases and volume,rehaemorrhagia cases were recorded,and adverse reactions were observed.Results After treatment,PVV and PVD of the two groups were significantly ameliorative (P ＜ 0.05),and there were no significantly different between two groups.Haemostatic time,blood transfusiorate,blood transfusiorate volume and rehaemorrhagia rate of the high dose group were significantly less than the low dose group (P ＜ 0.05).The clinical effective rate of the high dose group was significantly higher than that of the low dose group (P ＜ 0.05).The rate of adverse reactions of the high dose group was not significantly different from that of the low dose group.Conclusions High doses Octreotide combined with Lansoprazole in the treatment of hepatocirrhosis with upper gastrointestinal bleeding have a gain on hemostatic effect,and cannot increase adverse reactions significantly.