普萘洛尔辅助治疗肝硬化上消化道出血的效果及对血流动力学的影响(1)
[摘要]目的 探讨普萘洛尔辅助治疗肝硬化上消化道出血的效果及对血流动力学的影响。方法 回顾性分析本院2016年6月～2017年12月收治的75例肝硬化上消化道出血患者，根据临床用药方式分为对照组(35例)和研究组(40例)。对照组采取奥曲肽治疗，研究组采取奥曲肽联合普萘洛尔治疗。比较两组的临床治疗效果、不良反应发生率及对血流动力学的影响。结果 研究组治疗总有效率(92.50%)显著高于对照组的68.57%，差异有统计学意义(P<0.05)；治疗后，研究组的中心静脉压、平均动脉压、门静脉血流量、脾静脉血流量等指标均显著优于对照组，差异均有统计学意义(P<0.05)；研究组不良反应总发生率为7.50%，显著低于对照组的22.86%，差异有统计学意义(P<0.05)。结论 采用奥曲肽联合普萘洛尔治疗肝硬化上消化道出血临床效果显著，且安全性较高，有积极的临床价值。
[关键词]普萘洛尔；奥曲肽；肝硬化上消化道出血；效果；血流动力学
[中图分类号] R575.2 [文献标识码] A [文章编号] 1674-4721(2018)11(c)-0068-03
[Abstract] Objective To explore the effect of Propranolol on the treatment of upper gastrointestinal hemorrhage and its effect on hemodynamics. Methods Retrospective analysis of 75 patients with upper gastrointestinal hemorrhage in our hospital from June 2016 to December 2017. The patients were divided into the control group (n=35) and the study group(n=40)according to clinical medication. The control group was treated with Octreotide drugs， and the study group was treated with Octreotide combined with Propranolol. The effects of clinical treatment， adverse reactions and hemodynamics were compared between the two groups. Results The total effective rate of treatment in the study group was 92.50%， significantly higher than that in the control group (68.57%， P<0.05). After treatment， the results of central venous pressure， mean arterial pressure， portal vein blood flow and spleen venous blood flow were significantly better than those of the control group (P<0.05). The total inicidence of adverse reaction in the study group was 7.50%， which was significantly lower than that in the control group (22.86%)， the difference was statistically significant (P<0.05). Conclusion The clinical efficacy of Octreotide combined with Propranolol in the treatment of upper digestive tract hemorrhage in liver cirrhosis is significant and has high safety and positive clinical value.
[Key words] Propranolol； Octreotide； Liver cirrhosis upper gastrointestinal bleeding； Effect； Hemodynamics
肝硬化上消化道出血于臨床较为常见，是指于屈氏韧带上消化道出血点出现出血情况，一定程度威胁患者生命健康。临床治疗时采取奥曲肽联合普萘洛尔效果显著，奥曲肽能改善门静脉压及血流量情况，而普萘洛尔能降低上消化道出血量同时减少内脏血流量，治疗效果显著[1-2]。本研究探讨普萘洛尔辅助治疗肝硬化上消化道出血的效果及对血流动力学的影响，现报道如下。
1资料与方法
1.1一般资料
回顾性分析我院2016年6月～2017年12月收治的75例肝硬化上消化道出血患者。纳入标准：①有肝硬化疾病史或经穿刺活检、B超、CT等检查确诊为肝硬化疾病；②患者出现典型上消化道出血症状；③经胃镜、超声等检查明确诊断为肝硬化上消化道出血；④患者就诊前未采取内镜下治疗或手术治疗；⑤无奥曲肽、普萘洛尔药物禁忌证。排除标准：①肝癌、肝性疾病或其他严重肝病；②合并神经疾病或精神疾病；③治疗依从性差者。根据临床用药方式分为对照组和研究组。对照组35例中，男19例，女16例；年龄28～63岁，平均(49.25±3.24)岁；Child-Pugh分级为肝功能A级9例，B级17例，C级9例；12例为食管静脉曲张破裂出血，12例为胃底静脉曲张破裂出血，11例为门静脉高压性胃病出血。研究组40例中，男22例，女18例；年龄27～65岁，平均(49.35±3.21)岁；Child-Pugh分级为肝功能A级10例，B级20例，C级10例；13例为食管静脉曲张破裂出血，14例为胃底静脉曲张破裂出血，13例为门静脉高压性胃病出血。两组的性别、年龄、肝功能分级、出血部位等一般资料比较，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(白荣庆)
[关键词]普萘洛尔；奥曲肽；肝硬化上消化道出血；效果；血流动力学
[中图分类号] R575.2 [文献标识码] A [文章编号] 1674-4721(2018)11(c)-0068-03
[Abstract] Objective To explore the effect of Propranolol on the treatment of upper gastrointestinal hemorrhage and its effect on hemodynamics. Methods Retrospective analysis of 75 patients with upper gastrointestinal hemorrhage in our hospital from June 2016 to December 2017. The patients were divided into the control group (n=35) and the study group(n=40)according to clinical medication. The control group was treated with Octreotide drugs， and the study group was treated with Octreotide combined with Propranolol. The effects of clinical treatment， adverse reactions and hemodynamics were compared between the two groups. Results The total effective rate of treatment in the study group was 92.50%， significantly higher than that in the control group (68.57%， P<0.05). After treatment， the results of central venous pressure， mean arterial pressure， portal vein blood flow and spleen venous blood flow were significantly better than those of the control group (P<0.05). The total inicidence of adverse reaction in the study group was 7.50%， which was significantly lower than that in the control group (22.86%)， the difference was statistically significant (P<0.05). Conclusion The clinical efficacy of Octreotide combined with Propranolol in the treatment of upper digestive tract hemorrhage in liver cirrhosis is significant and has high safety and positive clinical value.
[Key words] Propranolol； Octreotide； Liver cirrhosis upper gastrointestinal bleeding； Effect； Hemodynamics
肝硬化上消化道出血于臨床较为常见，是指于屈氏韧带上消化道出血点出现出血情况，一定程度威胁患者生命健康。临床治疗时采取奥曲肽联合普萘洛尔效果显著，奥曲肽能改善门静脉压及血流量情况，而普萘洛尔能降低上消化道出血量同时减少内脏血流量，治疗效果显著[1-2]。本研究探讨普萘洛尔辅助治疗肝硬化上消化道出血的效果及对血流动力学的影响，现报道如下。
1资料与方法
1.1一般资料
回顾性分析我院2016年6月～2017年12月收治的75例肝硬化上消化道出血患者。纳入标准：①有肝硬化疾病史或经穿刺活检、B超、CT等检查确诊为肝硬化疾病；②患者出现典型上消化道出血症状；③经胃镜、超声等检查明确诊断为肝硬化上消化道出血；④患者就诊前未采取内镜下治疗或手术治疗；⑤无奥曲肽、普萘洛尔药物禁忌证。排除标准：①肝癌、肝性疾病或其他严重肝病；②合并神经疾病或精神疾病；③治疗依从性差者。根据临床用药方式分为对照组和研究组。对照组35例中，男19例，女16例；年龄28～63岁，平均(49.25±3.24)岁；Child-Pugh分级为肝功能A级9例，B级17例，C级9例；12例为食管静脉曲张破裂出血，12例为胃底静脉曲张破裂出血，11例为门静脉高压性胃病出血。研究组40例中，男22例，女18例；年龄27～65岁，平均(49.35±3.21)岁；Child-Pugh分级为肝功能A级10例，B级20例，C级10例；13例为食管静脉曲张破裂出血，14例为胃底静脉曲张破裂出血，13例为门静脉高压性胃病出血。两组的性别、年龄、肝功能分级、出血部位等一般资料比较，差异无统计学意义(P>0.05)，具有可比性。, 百拇医药(白荣庆)