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生长抑素联合泮托拉唑治疗肝硬化合并上消化道出血的疗效观察
Effect of somatostatin combined with pantoprazole in treatment of liver cirrhosis with upper gastrointestinal hemorrhage
文章发布日期:2016年02月06日  来源:  作者:高成广,谢峰,冯亚东  点击次数:2111次  下载次数:433次

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【摘要】:目的评价生长抑素联合泮托拉唑治疗肝硬化合并上消化道出血的疗效。方法选取2011年1月-2015年8月泰州市姜堰中医院收治的肝硬化合并上消化道出血患者70例,随机分为两组,联合组与对照组各35例。两组患者入院后均给予常规基础治疗,联合组加用生长抑素联合泮托拉唑治疗,对照组予以生长抑素治疗。观察治疗前后两组临床疗效、止血时间、输血量、48 h再出血率、住院时间及不良反应。计量资料组间比较采用t检验,计数资料组间比较采用χ2检验, 等级资料组间比较采用Wilcoxon秩和检验。结果联合组的临床疗效明显优于对照组,联合组总有效率94.3%,对照组总有效率62.9%,两组临床疗效差异有统计学意义(χ2=10.27,P<005),联合组显效率为60.0%,对照组显效率34.3%,两组显效率差异无统计学意义(χ2=2.80,P>005);在止血时间、输血量、住院时间方面,联合组明显低于对照组,两组比较差异均有统计学意义(t值分别为9.036、6419、4186,P值均<0.05);联合组48 h再出血率低于对照组,两组间差异无统计学意义 (χ2=0.22,P>0.05);不良反应发生率两组均较轻,差异无统计学意义(χ2=0.16,P>0.05)。结论生长抑素联合泮托拉唑治疗肝硬化合并上消化道出血疗效优于单用生长抑素,止血时间短、输血量少、再出血率低、住院时间短且治疗期间无严重不良反应,是一种治疗肝硬化合并上消化道出血的有效方法。
【Abstract】:ObjectiveTo investigate the effect of somatostatin (SS) combined with pantoprazole in the treatment of liver cirrhosis with upper gastrointestinal hemorrhage (UGIH). MethodsA total of 70 patients with liver cirrhosis and UGIH who were admitted to Jiangyan Hospital of Traditional Chinese Medicine from January 2011 to August 2015 were enrolled and randomized into combination group and control group, with 35 patients in each group. After admission, the patients in both groups were given conventional basic treatment; the patients in the combination group were given SS combined with pantoprazole, and those in the control group were given SS alone. The treatment outcome, time to hemostasis, volume of blood transfusion, 48-hour rebleeding rate, length of hospital stay, and adverse events before and after treatment were observed and compared between the two groups. The t-test was applied for comparison of continuous data between groups, the chi-square test was applied for comparison of categorical data between groups, and the Wilcoxon rank sun test was applied for comparison of ranked data between groups. ResultsThe combination group had a significantly better treatment outcome compared with the control group, with overall response rates of 94.3% and 62.9%, respectively (χ2=10.27, P<0.05); the marked response rate was 600% in the combination group and 34.3% in the control group, and showed no significant difference between the two groups (χ2=280, P>0.05); the combination group had a significantly shorter time to hemostasis, a significantly lower volume of blood transfusion, and a significantly shorter length of hospital stay compared with the control group (t=9.036, 6.419, and 4.186, all P<0.05); the combination group had a lower 48-hour rebleeding rate than the control group, but the 48-hour rebleeding rate showed no significant difference between the two groups (χ2=0.22, P>0.05); the incidence rate of adverse events was similar between the two groups and showed no significant difference (χ2=0.16, P>0.05), and the adverse events in both groups were mild. ConclusionSS combined with pantoprazole has better efficacy than SS alone in the treatment of liver cirrhosis with UGIH. Patients treated with SS combined with pantoprazole have a short time to hemostasis, a low volume of blood transfusion, a low rebleeding rate, and a short length of hospital stay, with no serious adverse events during treatment. The combination therapy is an effective treatment of liver cirrhosis with UGIH.
【关键字】:肝硬化;食管和胃静脉曲张;生长抑素;质子泵抑制剂
【Key words】:liver cirrhosis; esophageal and gastric varices; somatostatin, proton pump inhibitors
【引证本文】:高成广, 谢峰, 冯亚东. 生长抑素联合泮托拉唑治疗肝硬化合并上消化道出血的效果观察[J]. 临床肝胆病杂志, 2016, 32(2): 284-287.

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