Effect of Propranolol combined with Octreotide on hemodynamics and hemostatic effect in patients with liver cirrhosis and upper gastrointestinal bleeding
LI Xiao-qing
Department of Gastroenterology, Fengcheng People′s Hospital, Jiangxi Province, Fengcheng 331100, China
摘要目的 上消化道出血是肝硬化常见并发症，其治疗一直是临床关注的重点问题，本研究选用普萘洛尔联合奥曲肽治疗，探讨其在肝硬化上消化道出血患者中的应用。方法 选取2017年3月～2019年6月我院收治的66例肝硬化上消化道出血患者作为研究对象，按照随机数字表法分为对照组（n=33）和观察组（n=33）。对照组采用奥曲肽治疗，观察组采用普萘洛尔联合奥曲肽治疗，比较两组胃左静脉、脾静脉、门静脉指标及止血效果。结果 观察组治疗后胃左静脉内径及分流指数低于对照组，差异有统计学意义（P＜0.05）；观察组治疗后脾静脉及门静脉内径、血流量低于对照组，平均速度高于对照组，差异均有统计学意义（P＜0.05）；观察组的止血时间短于对照组，差异有统计学意义（P＜0.05）；观察组治疗后2 d 后再出血率低于对照组，差异有统计学意义（P＜0.05）。结论 采用普萘洛尔联合奥曲肽治疗肝硬化上消化道出血可缩短止血时间，降低治疗后2 d 再出血率，改善患者胃左静脉、脾静脉及门静脉指标。
Abstract：Objective Upper gastrointestinal bleeding was a common complication in liver cirrhosis, and its treatment has always been a key clinical concern.In this study, Propranolol combined with Octreotide was used to explore its effect in patients with liver cirrhosis and upper gastrointestinal bleeding.Methods Sixty-six patients with liver cirrhosis accompanied with upper gastrointestinal bleeding who were treated in our hospital from March 2017 to June 2019 were selected as the research subjects.They were divided into control group (n=33) and observation group (n=33) according to the random number table method.In the control group, Octreotide was used, and in the observation group, Propranolol combined with Octreotide was applied.The indexes of left gastric vein, splenic vein，portal vein and hemostatic effect of the two groups were compared.Results The diameter of the left gastric vein and the shunt index in the observation group after treatment were lower than those in the control group, and the differences were statistically significant(P＜0.05).The diameter and blood flow of the splenic vein and portal vein in the observation group were lower than those in the control group, and the average speed was higher than that in the control group, with statistical differences(P＜0.05).The hemostatic time in the observation group was shorter than that in the control group, and the difference was statistically significant (P＜0.05).The re-bleeding rate two days after therapy in the observation group was lower than that in the control group, and the difference was statistically significant (P＜0.05).Conclusion The use of Propranolol combined with Octreotide in the treatment of upper gastrointestinal bleeding in liver cirrhosis can shorten the hemostatic time, reduce the re-bleeding rate after two days, and improve the indexes of the left gastric vein, splenic vein and portal vein of patients.
黎筱青. 普萘洛尔联合奥曲肽对肝硬化上消化道出血患者血流动力学及止血效果的影响[J]. 中国当代医药, 2020, 27(11): 48-51.
LI Xiao-qing. Effect of Propranolol combined with Octreotide on hemodynamics and hemostatic effect in patients with liver cirrhosis and upper gastrointestinal bleeding. 中国当代医药, 2020, 27(11): 48-51.
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