奥曲肽联合奥美拉唑治疗肝硬化上消化道出血的临床观察.doc

《奥曲肽联合奥美拉唑治疗肝硬化上消化道出血的临床观察.doc》由会员上传分享，免费在线阅读，更多相关内容在工程资料-天天文库。

1、奥Illi肽联合奥美拉卩坐治疗肝驶化上消化道出血的临床观察［摘要］目的探讨奥曲肽联合奥美拉啤治疗肝硬化上消化道出血的临床疗效。方法将60例患者随机分为观察纟fl和对照纟R各30例,观察纟刃、''/「用奥1111肽联合奥美拉I酬治疗，奥曲肽先予0.lmg静脉推注,然后以25ug/h持续静脉滴注48〜72h;奥美拉哇40mg加入生理盐水lOOmL静脉滴注持续48〜72h。对照组使用垂体后叶素，先予20U静脉推注,然后以15U/h微泵维持48〜72h;观察各组的止血效果。结果观察纽•治疗总有效率为93.33%,高

2、于对照纽的56.67%,羞异具有显著性(P〈0.01)。结论奥曲肽联合奥美拉卩坐是治疗肝便化上消化道出血的有效措施Z—，副反应小，值得临床推广。［关键词］奥曲肽;奥美拉哇；垂体后叶素；上消化道出血；肝硬化［屮图分类号］R975;R573.2;R575.2［文献标识码］A［文章编号］1673-9701(2009)34-40-02CombinationofOctreotideandOmeprazoleinTreatmentofLiverCirrhosiswithUpperGastrointestinalHemo

3、rrhageCHENHonglianSUNYouliTheThirdAffiliateclHospitalofLuoheMedicalCollege,Luohe462000,China［Abstract］ObjectiveToexplorethecurativeeffectofoctreotidecombincdwithomeprazoleinthetreatmentofuppergastrointestinalhemorrhagein1ivercirrhosis.MethodsSixtylivercirr

4、hosispatientswithuppergastrointestinalhemorrhageweredividedrandomLyintoobservationgroup(30cases)andcontrolgroup(30cases).Theobservationgroupwastreatedwithoctreotideandomeprazole,firstintravenousbolusinjectionofoctreotide0.lmgfollowedbycontinuousintravenous

5、infusionofoctreotide25ug/hfor48、72h,andthencontinuousintravenousinfusionofomeprazole40mgfor48、72hwithadditionofnormalsalinelOOmL・Thecontrolgroupwastreatedwithpituitrin,firstintravenousbolusinjectionofpituitrin20Uandthenintravenousinfusionofpituitrin15U/hwi

6、thamicro-pumpfor48~72h・Thehemostaticeffectineachgroupwasobserved・ResultsThetotaleffectiverateoftheobservationgroup(93.33%)wasbetterthanthatofthecontrolgroup(56.67%),withasignificantdifferencebetweenthetwogroups(P<0・01).ConelusionThecombineduseofoctreotidea

7、ndomeprazoleiseffectiveinthetreatmentofuppergastrointestinalhemorrhageinlivercirrhosis,withfewsideeffects,worthyofbeingrecommendedinclinicalpractice・［Keywords］Octreotide;Omeprazole;Pituitrin;Uppergastrointestinalhemorrhage;Livercirrhosis上消化道出血是肝硬化最常见并发症，多突

8、然发生大量呕血和(或)黑便，引起失血性休克或诱发肝性脑病，病情凶险，病死率高。传统治疗肝驶化合并上消化道出血的方法有三腔二囊管压迫止血及使用垂体后叶素静脉注射等，操作复杂，副作用多而限制了其广泛应用。2006年10月〜2008年10月期间我们采用奥曲肽联合奥美拉哇治疗肝硬化合并上消化道岀血，取得了满意疗效,现报道如下。1资料与方法1.1一般资料60例患者中男45例，女15例;年龄28〜81岁，平均(50.3±4.