目的評(píng)價(jià)不同劑量奧曲肽聯(lián)合蘭索拉唑治療肝硬化合并上消化道出血療效及安全性。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奧曲肽聯(lián)合蘭索拉唑治療,根據(jù)奧曲肽的劑量不同分為大劑量組（40例）與小劑量組（40例）,治療前后分別彩超測定門靜脈平均流速（PVV）與門靜脈內(nèi)徑（PVD）,記錄止血時(shí)間、輸血例數(shù)、輸血量及再出血例數(shù),觀察不良反應(yīng)。結(jié)果治療后2組PVV與PVD均明顯改善（P<0.05）,組間比較無明顯差異。大劑量組止血時(shí)間、輸血率、輸血量及再出血率均明顯少于小劑量組（P<0.05）。大劑量組總有效率為90.0%,小劑量組為70.0%,兩組比較差異顯著（P<0.05）。大劑量組不良反應(yīng)發(fā)生率與小劑量組無明顯差異。結(jié)論大劑量奧曲肽聯(lián)合蘭索拉唑治療肝硬化合并上消化道出血對(duì)止血作用有增益,且不會(huì)明顯增加不良反應(yīng)。

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.