Comparison of efficacy of carvedilol and propranolol combined with octreotide on upper gastrointestinal hemorrhage in patients with liver cirrhosis
Objective To compare the efficacy of carvedilol and propranolol combined with octreotide in the treatment of upper gastrointestinal hemorrhage in patients with liver cirrhosis.Methods A total of 72 patients with liver cirrhosis and upper gastrointestinal hemorrhage who were admitted to No.928 Hospital of Joint Logistic Support Forces of PLA from January 2020 to January 2022 were selected as research objects.The patients were divided into control group and observation group by random number table method,with 36 patients in each group.The control group was treated with propranolol and octreotide,and the observation group was treated with carvedilol and octreotide.Portal vein blood flow,splenic vein blood flow,hepatic venous wedge pressure(WHVP),hepatic venous free pressure(FHVP),and hepatic venous pressure gradient(HVPG)were recorded before and after treatment.The treatment efficacy,rebleeding rate within 48 h,length of hospital stay and adverse reactions were compared between the two groups.Results The total effective rate of treatment in the observation group was significantly higher than that in the control group(P＜0.05).There was no significant difference in the rebleeding rate within 48 h,the length of hospital stay,or the incidence of adverse reactions between the two groups(P＞0.05).There was no significant difference in the portal venous blood flow,splenic venous blood flow,WHVP,FHVP,or HVPG between the two groups before treatment(P＞0.05).The portal venous blood flow,splenic venous blood flow,WHVP,and HVPG in the observation group were significantly lower than those in the control group after treatment(P＜0.05),while there was no significant difference in the FHVP between the two groups(P＞0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P＞0.05)Conclusion Carvedilol combined with octreotide is more effective in treating upper gastrointestinal hemorrhage in patients with liver cirrhosis than propranolol combined with octreotide.It can significantly reduce HVPG and improve portal and splenic venous blood flow,with a good safety profile.It is worthy of clinical application.
Liver cirrhosisAcute massive hemorrhage of upper digestive tractCarvedilolPropranololOctreotide
万方数据
维普
