目的 探討奧曲肽聯(lián)合普萘洛爾治療肝硬化食管胃底靜脈曲張破裂后出血的臨床效果。方法 選擇2010年1月—2014年5月在安康市中心醫(yī)院診治的肝硬化食管胃底靜脈曲張破裂后出血患者200例,根據(jù)隨機數(shù)字表法分為治療組和對照組各100例。對照組口服普萘洛爾治療,治療組在對照組治療的基礎上給予奧曲肽注射液治療,治療觀察周期為7 d。觀察兩組的止血時間和輸血量,監(jiān)測丙氨酸氨基轉(zhuǎn)移酶(ALT)和天門冬氨酸氨基轉(zhuǎn)移酶(AST)的變化。治療結束后隨訪1年,比較患者的中位生存時間和1年生存率。結果 治療組的止血時間與輸血量分別為(21.56±3.12)h和(243.59±45.33)mL,明顯少于對照組的(80.24±5.33)h和(529.45±92.45)mL(P<0.05)。兩組治療后血清ALT與AST水平都明顯降低(P<0.05),同時治療后治療組的ALT與AST水平也明顯低于對照組(P<0.05)。隨訪至2015年5月,治療組的中位生存時間與1年生存率分別為(47.44±6.44)個月與97.0%,而對照組分別為(34.98±5.29)個月與89.0%,治療組比對照組要更優(yōu)(P<0.05)。結論 奧曲肽聯(lián)合普萘洛爾治療肝硬化食管胃底靜脈曲張破裂后出血能發(fā)揮更好的止血效果,可促進肝功能的恢復,延長患者的生存時間,有很好的應用價值。

Objective To investigate the clinical effects of octreotide and propranolol for treating cirrhosis combined esophageal varices bleeding. Methods From January 2010 to May 2014, 200 cases of cirrhosis combined esophageal varices bleeding in Ankang City Central Hospital were selected, accorded to the random number table were equally divided into treatment group and control group, the patients in control group were given the oral propranolol therapy, and the patients in treatment group received octreotide and propranolol treatment on the basis of the control group, the treatment observation period was 7 d. Results The bleeding time and blood transfusion volume in the treatment group were (21.56 ± 3.12) h and (243.59 ± 45.33) mL that were significantly less than the control group of (80.24 ± 5.33) h and (529.45 ± 92.45) mL (P < 0.05). After treatment, the concentration of serum alanine aminotransferase and aspartate aminotransferase was significantly lower (P < 0.05), while the concentration of alanine aminotransferase and aspartate aminotransferase in the treatment group after treatment was significantly lower than that of the control group (P <0.05). Followed-up to May 2015, the median survival time and 1-year survival rates in the treatment group were (47.44 ± 6.44) months and 97.0%, while those in the control group were (34.98 ± 5.29) months and 89.0%, and those in the treatment group were better than control group (P <0.05). Conclusion The octreotide and propranolol for treating cirrhosis combined esophageal varices bleeding have better hemostatic effect, and they can promote the recovery of liver function and prolong survival time of patients, which has a good application value.