童银

[摘要] 目的 探讨奥美拉唑联合奥曲肽治疗肝硬化上消化道出血（UGIB）的效果。 方法 选取2016年4月至2019年11月在我院治疗的90例肝硬化UGIB患者，随机分为观察组和对照组，每组各45例。对照组给予奥美拉唑治疗，观察组给予奥美拉唑联合奥曲肽治疗，对不同治疗方案的疗效进行分析。 结果 观察组治疗总有效率为93.33%，高于对照组的68.89%，两组比较，差异有统计学意义（P<0.05）。观察组患者止血时间、住院时间、48 h再出血率分别为（19.29±1.88）h、（5.29±0.72）d、2.22%，明显优于对照组的（36.51±3.81）h、（7.89±1.21）d、13.33%，两组比较，差异有统计学意义（P<0.05）。观察组输血量为（3.59±2.23）U，与对照组的（3.70±2.21）U比较，差异无统计学意义（P>0.05）。治疗后，观察组患者GBS评分为（4.09±0.78）分，明显低于对照组的（4.78±0.97）分，两组比较，差异有统计学意义（P<0.05）。观察组的不良反应总发生率为4.44%，与对照组的6.67%比较，差异无统计学意义（P>0.05）。 结论 奥美拉唑联合奥曲肽治疗肝硬化UGIB能迅速止血，疗效确切，可有效预防出血再发生，降低UGIB危急程度，且联合用药不会明显增加不良反应的发生，安全性高，值得推广。

[关键词] 奥美拉唑;奥曲肽;肝硬化UGIB;危急程度;再出血;安全性

[中图分类号] R575.2          [文獻标识码] B          [文章编号] 1673-9701（2021）07-0054-03

Effect of omeprazole combined with octreotide on upper gastrointestinal bleeding in patients with liver cirrhosis

TONG Yin

Department of Infectious Diseases， Zhongxiang People′s Hospital in Hubei Province， Zhongxiang   431900， China

[Abstract] Objective To explore the effect of omeprazole combined with octreotide on upper gastrointestinal bleeding （UGIB） in patients with liver cirrhosis. Methods A total of 90 patients with hepatic cirrhosis complicated with UGIB treated in our hospital from April 2016 to November 2019 were randomly divided into the control group（n=45） and the study group（n=45）. The control group was treated with omeprazole， while the observation group was treated with omeprazole combined with octreotide. The curative effects of both groups were analyzed. Results The total effective rate of the observation group was 93.33%， which was higher than 68.89% of the control group， and the difference was statistically significant（P<0.05）. The hemostatic time， hospitalization time and 48-hour rebleeding rate in the observation group were（19.29±1.88） h， （5.29±0.72） d and 2.22%， which were significantly better than those in the control group（36.51±3.81） h， （7.89±1.21） d and 13.33%， respectively. with statistically significant difference（P<0.05）. The amount of blood transfusion in the observation group was（3.59±2.23） U， which was not significantly different from that in the control group（3.70±2.21） U， with no statistically significant differences（P>0.05）. After treatment， the GBS score of patients in the observation group was（4.09±0.78） points， which was significantly lower than that of patients in the control group（4.78±0.97） points， and the difference was statistically significant（P<0.05）. The total incidence of adverse reactions in the observation group was 4.44%， which was not significantly different from 6.67% in the control group（P>0.05）. Conclusion Omeprazole combined with octreotide can stop bleeding quickly and effectively. It can effectively prevent the recurrence of bleeding and reduce the critical degree of UGIB. Moreover， the combination of omeprazole and octreotide will not significantly increase the incidence of adverse reactions， which is safe and worthy of promotion.

[Key words] Omeprazole; Octreotide; Liver cirrhosis UGIB; Degree of criticality; Recurrent hemorrhage; Safety

肝硬化引起的消化道出血，是肝硬化最常见的并发症，且治疗不及时可能会引起预后不良。肝硬化上消化道出血常见于门静脉高压引起的食管胃底静脉曲张破裂出血，表现为突发的大量呕血或柏油样便，严重者可能出现出血性休克[1-2]。上消化道出血（Upper gastrointestinal bleeding，UGIB）的主要临床表现为呕血和（或）黑便及周围循环衰竭[3]，是临床常见的急症。抢救是否得当，处理是否及时、正确关系到患者的生命安危，也关系着患者病情恢复后的生活质量。本研究选取了2016年4月至2019年11月我院收治的90例肝硬化UGIB患者，其中45例患者给予奥美拉唑联合奥曲肽治疗，取得了满意的效果，现报道如下。

1 资料与方法