摘要
目的 探讨特利加压素联合凝血酶对肝硬化食管胃静脉曲张出血(EGVB)患者疗效及凝血功能、门静脉压(PVP)的影响.方法 选取2021年9月—2023年11月焦作市第二人民医院收治的60 例肝硬化EGVB患者为研究对象,依据随机信封法将其分为对照组、观察组,各30 例.对照组给予凝血酶,观察组给予凝血酶+特利加压素.比较2组治疗后临床疗效、黑便及呕血现象消失时间、止血时间、输血量、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、PVP、中心静脉压(CVP)、纤维蛋白原(FIB)、D-二聚体(D-D)、门静脉内径、门静脉血流速度、不良反应.结果 观察组临床总有效率96.67%高于对照组的80.00%,差异有统计学意义(P＜0.05);与对照组相比,观察组黑便、呕血、出血消失时间更短,输血量更少,差异有统计学意义(P＜0.05);治疗后2组APTT、PT水平降低,D-D、FIB水平升高,其中观察组PT、APTT水平高于对照组,差异有统计学意义(P＜0.05);治疗后观察组PVP及门静脉内径水平均明显下降,差异有统计学意义(P＜0.05);治疗后2组FIB、D-D水平比较差异无统计学意义(P＞0.05);治疗前后及治疗后2组CVP及门静脉血流速度比较,差异均无统计学意义(P＞0.05);观察组不良反应发生率26.67%与对照组13.33%相比,差异无统计学意义(P＞0.05).结论 特利加压素联合凝血酶治疗肝硬化EGVB患者疗效确切,可减少出血,降低PVP,改善凝血功能.
Abstract
Objective To investigate the effects of Teripressin combined with Thrombin on the efficacy,coagulation function and portal vein pressure(PVP)in patients with esophageal and gastric variceal bleeding(EGVB)in cirrhotic patients.Methods 60 patients with EGVB in cirrhosis admitted to Jiaozuo Second People's Hospital from September 2021 to November 2023 were selected as the study objects,and were divided into control group and observation group according to random envelope method,with 30 cases in each group.The control group was given Thrombin,and the observation group was given Thrombin+Teripressin.The clinical efficacy,disappearance time of black feces and hematemesis,hemostasis time,blood transfusion volume,prothrombin time(PT),activated partial thromboplastin time(APTT),PVP,central vein pressure(CVP),fibrinogen(FIB),D-dimer(D-D),portal vein diameter,portal vein flow velocity and adverse reaction were compared between the two groups after treatment.Results The total clinical effective rate of observation group was 96.67%higher than that of control group(80.00%),the difference was statistically significant(P＜0.05).Compared with the control group,the disappearance time of black stool,hematemesis and hemorrhage in the observation group was shorter,and the blood transfusion volume was less,the difference was statistically significant(P＜0.05).After treatment,the levels of APTT and PT in 2 groups were decreased,and the levels of D-D and FIB were increased,and the levels of PT and APTT in observation group were higher than those in control group,with statistical significance(P＜0.05).After treatment,the levels of PVP and portal vein diameter in the observation group were significantly decreased,and the difference was statistically significant(P＜0.05).There were no significant differences in FIB and D-D levels between the two groups after treatment(P＞0.05).There were no significant differences in CVP and portal blood flow velocity between the two groups before and after treatment(P＞0.05).The incidence of adverse reactions in the observation group was 26.67%compared with 13.33%in the control group(P＞0.05).Conclusion Teripressin combined with Thrombin is effective in treating EGVB patients with cirrhosis.It can reduce bleeding,decrease PVP and improve coagulation function.
维普
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