奥曲肽联合奥美拉唑治疗肝硬化并上消化道出血的疗效评价-论文.pdf

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1、2013年第17卷第19期实用临床医药杂志JoumalofClinicalMedicineinPractice·97·奥曲肽联合奥美拉唑治疗肝硬化并上消化道出血的疗效评价张健，吴友伟，史丽萍(陕西省人民医院消化内二科，陕西西安，710068)摘要：目的探讨奥曲肽联合奥美拉唑治疗肝硬化并上消化道出血的fl缶床效果。方法选取本院2009年3月一2012年5月收治的肝硬化导致的上消化道出血患者62例，随机分成实验组和对照组，每组31例。实验组静脉滴注奥曲肽和奥美拉唑，对照组进行常规的垂体后叶素治疗，比较2组的临床疗效。结

2、果实验组的总有效率显著高于对照组(P<0．05)；实验组平均出血时间、48h再出血率、不良反应发生率和死亡率显著低于对照组(P<0．05)；实验组治疗后血清胰高血糖素浓度和NO浓度的下降幅度显著大于对照组(P<0．05)。结论与传统的垂体后叶素治疗肝硬化合并上消化道出血相比，奥曲肽联合奥美拉唑能显著提高治疗的有效率，缩短出血时间，降低不良反应和再出血的发生率，降低死亡率，值得J临床推广应用。关键词：奥曲肽；奥美拉唑；上消化道出血；肝硬化中图分类号：R657．3文献标志码：A文章编号：1672—2353(2013)1

3、9—097—03DOI：10．7619~cmp．201319035Effectofoctreotidecombinedwithomeprazoleintreatmentoflivercirrhosiscomplicatedbyuppergastr0intestinalhemorrhageZHANGJian．、VUYouwei。SHILiping(ShanaciP加vincialPeople'sHospital，*an，Shar~i，710068)ABSTRACT：ObjectiveToobserveandanaly

4、zetheeffectOfoctreotidecombinedwithomeprazoleintreatmentoflivercirrhosiscomplicatedbyuppergastrointestinalhemorrhage．Meth-odsSixty—tWOpatients，receivedfromMarch2009toMay2012，sufferingfromlivercirrhosiscomplicatedbygastrointestinalhemorrhageweredividedintoexper

5、imentgroupandcontrolgroup，eachwith31patients．Theexperimentgroupreceivedthetreatmentofoctreotideandomeprazolewhilethecontrolgroupunderthetreatmentofpituitrin．Thecurativeeffectsoftwogroupswereob—servedandanalyzed．ResultsThetotaleffectivenessrateintheexperimentgr

6、oupwasobviouslyhigherthanthatinthecontrolgroup(P<0．05)．Theaveragetimeofbleedingwasshortened，whiletherateofrebleedingandsideeffectwerereduced，alsotherateofdeathwereloweredsignifi—cantly(P<0．05)．Aftertreatment，thedeclinedegreeofconcentrationofglucagonsandNOinthe

7、experimentwasobviouslylower，comparedwiththecontrolgroup(P<0．05)．ConclusionCom—paredwiththetraditionaltreatmentofpituitrin，octreotidecombinedwithomeprazolecanraisethetotaleffectivenessrate，reducethebleeding，sideeffectandrebleedingandreducetherateofdeath．Sooctre

8、otidecombinedwithomeprazoleshouldbepromotedinclinicaltreatment．KEYWORDS：octreotide；omeprazole；uppergastrointestinalhemorrhage；livercirrhosis上消化道出血是肝硬化的常见并发症，病情传统的以垂体后叶素进行治疗，但易导致患者腹