内镜下套扎联合奥美拉唑钠治疗肝硬化上消化道出血及对血流动力学、凝血功能和不良反应的影响被引量：16

Curative effect of endoscopic ligation combined with omeprazole sodium on upper gastrointestinal hemorrhage in liver cirrhosis and its influences on hemodynamics, coagulation function and adverse reactions

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摘要目的:探讨内镜下套扎联合奥美拉唑钠治疗肝硬化上消化道出血(LC-UGH)及对血流动力学、凝血功能和不良反应的影响。方法:选取124例LC-UGH患者作为研究对象,按照治疗方案不同分为药物联合组(n=60)和内镜套扎组(n=64)。药物联合组采用内镜下套扎联合奥美拉唑钠治疗;内镜套扎组采用内镜下套扎。观察两组患者止血效果、治疗前后血流动力学、凝血功能、应激反应指标变化及不良反应情况。结果:与内镜套扎组比较,药物联合组的输血量少,止血时间、住院时间短,再出血率低(P<0.05)。治疗后,与内镜套扎组比较,药物联合组PT、APTT短、FBL水平高,hs-CRP、Cor水平低,门静脉和脾静脉血流量低(P<0.05);两组总不良反应发生率比较,差异无统计学意义(P>0.05)。结论:内镜套扎联合奥美拉唑钠可有效改善血流动力学和凝血功能,提高止血效果,降低再出血的风险,较单用内镜套扎受益更多。 Objective:To explore the curative effect of endoscopic ligation combined with omeprazole sodium on upper gastrointestinal hemorrhage in liver cirrhosis(LC-UGH) and its influences on hemodynamics, coagulation function and adverse reactions.Methods:A total of 124 patients with LC-UGH were enrolled.According to different treatment methods, they were divided into drug combination group(n=60,endoscopic ligation combined with omeprazole) and endoscopic ligation group(n=64,endoscopic ligation).The hemostatic effect, hemodynamics, coagulation function, stress response indexes and adverse reactions were observed before and after treatment.Results:Compared with the endoscopic ligation group, the drug combination group had less blood transfusion, shorter hemostasis time and hospital stay, and lower rebleeding rate(P<0.05).After treatment, compared with the endoscopic ligation group, the PT and APTT were shorter, the FBL level was higher, the hs-CRP and Cor levels were lower, and the blood flow of portal vein and splenic vein was lower in the drug combination group(P<0.05).There was no significant difference in total incidence of adverse reactions between drug combination group and endoscopic ligation group(P>0.05).Conclusion:Endoscopic variceal ligation combined with omeprazole can effectively improve hemodynamics and coagulation function, improve hemostatic effect, and reduce the risk of rebleeding, which is more beneficial than endoscopic variceal ligation alone.

作者王萍王实朴张春涛陶凯 WANG Ping;WANG Shi-pu;ZHANG Chun-tao;TAO Kai(Department of Emergency Medicine,General Hospital of Western Theater Command of Chinese People’s Liberation Army,Chengdu 610083,Sichuan,China)

机构地区西部战区总医院急诊医学科

出处《川北医学院学报》 CAS 2023年第1期25-27,58,共4页 Journal of North Sichuan Medical College

基金国家自然科学基金青年项目(82101467)。

关键词肝硬化消化道出血奥美拉唑钠内镜套扎血流动力学凝血功能不良反应 Liver cirrhosis Gastrointestinal hemorrhage Omeprazole sodium Endoscopic ligation Hemodynamics Coagulation function Adverse reaction