目的:比较观察奥曲肽与垂体后叶素治疗肝硬化上消化道出血的疗效。
方法:在此前瞻性中,随机化,打开,单盲,控制,和单中心研究,将肝硬化上消化道出血患者分为对照组(给予垂体后叶素治疗)和实验组(给予奥曲肽治疗)。有效时间,止血时间,观察并记录两组的平均出血量,以及不良反应的发生率,再出血率,比较两组的治疗总有效率。
结果:纳入2017年3月至2018年9月肝硬化上消化道出血患者132例。通过单盲方法,随机分为对照组(n=66)和实验组(n=66)。与对照组相比,实验组药物的有效时间和止血时间明显缩短,而患者的平均出血量较低(平均P<0.05)。与对照组相比,实验组总有效率较高,而不良反应发生率较低(平均P<0.05)。在1年的随访中,两组早期和晚期再出血率及出血相关死亡率差异无统计学意义(均P>0.05)。
结论:在治疗肝硬化上消化道出血中,奥曲肽优于垂体后叶素,具有起效快的优点,止血时间短,不良反应少,有助于控制再出血率和出血相关死亡率。
The objective of the study was to compare and observe the therapeutic effect of octreotide and pituitrin in upper gastrointestinal hemorrhage caused by cirrhosis.
In this prospective, randomized, open, single-blind, controlled, and single-center study, patients with upper gastrointestinal hemorrhage induced by cirrhosis were divided into control group (treated with pituitrin) and experimental group (treated with octreotide). The effective time, hemostasis time, and average bleeding volume of the two groups were observed and recorded, and the incidence of adverse reactions, rebleeding rate, and total effective rate of the two groups were compared.
One hundred and thirty-two patients with upper gastrointestinal hemorrhage caused by cirrhosis were included from March 2017 to September 2018. By a single-blind method, the patients were randomly divided into control group (n = 66) and experimental group (n = 66). Compared with the control group, the effective time and hemostasis time of the drug were significantly shorter in the experimental group, whereas the average bleeding volume of patients was lower (average P < 0.05). Compare with the control group, the total effective rate was higher in the experimental group, whereas the incidence of adverse reactions was lower (average P < 0.05). During 1-year follow-up, early and late rebleeding rates and hemorrhage-related mortality between the two groups have no difference (average P > 0.05).
In the treatment of upper gastrointestinal hemorrhage in cirrhosis, octreotide is superior to pituitrin, with advantages of quick onset, short hemostasis time, and less adverse reactions, which is helpful to control the rebleeding rate and bleeding-related mortality.