He Xuni, Dai Zhuhua, Shi Peina, Hong Jiemin
Gastroenterology Department, Ningbo Yinzhou No. 2 Hospital, No. 998, Qianhe Road, Yinzhou District, Ningbo City, Zhejiang Province 315199, China.
Evid Based Complement Alternat Med. 2021 Oct 13;2021:6548479. doi: 10.1155/2021/6548479. eCollection 2021.
Liver cirrhosis is a common, often progressive, and usually fatal disorder. Upper gastrointestinal bleeding is a leading cause of death in patients with liver cirrhosis. The purpose of this study was to evaluate the effectiveness of somatostatin combined with restricted fluid resuscitation in the treatment of upper gastrointestinal bleeding in the patients with liver cirrhosis.
From January 2018 to December 2020, 84 patients with liver cirrhosis complicated by upper gastrointestinal bleeding admitted to the Department of Gastroenterology of Ningbo Yinzhou No. 2 Hospital were selected as study participants. They were randomly assigned into the study group ( = 42) and control group ( = 42). All patients were given intravenous drip of somatostatin. The study group was supplemented with restricted fluid resuscitation therapy. The hemoglobin (Hb), platelet, fibrinogen, hematocrit, transfusion volume of red blood cells, hemostatic time, hemostatic rates in 0 h-24 h, 24 h-48 h, and >48 h, rebleeding rates, resuscitation rate, and incidence rates of complications were compared between the two groups 48 h after treatment.
It was found that the Hb, platelet, fibrinogen, and hematocrit were notably increased in the study group compared to the control group 48 h after treatment ( < 0.01). The proportion of patients with excellent response was notably higher in the study group than in the control group ( < 0.05). The overall response rate of the study group was 90.48%, which was significantly higher than 71.43% in the control group ( < 0.05). The study group had lower transfusion volume of red blood cells, shorter hemostatic time, and lower rebleeding rates than the control group ( < 0.01). The hemostatic rate of 0 h-24 h in the study group was remarkably higher than that in the control group ( < 0.05). The hemostatic rate of >48 h in the study group was lower than that in the control group ( < 0.05). The overall incidence rate of complications in the study group was 9.52%, which was significantly lower than 30.95% in the control group ( < 0.05).
These data suggest that intravenous drip of somatostatin followed by restricted fluid resuscitation leads to a better clinical efficacy in treating upper gastrointestinal bleeding in patients with liver cirrhosis considering higher resuscitation rate and hemostatic rate and reduced incidence of complications, which is conducive to the recovery of patients and worthy of further clinical promotion.
肝硬化是一种常见的、通常呈进行性发展且往往致命的疾病。上消化道出血是肝硬化患者的主要死亡原因。本研究旨在评估生长抑素联合限制性液体复苏治疗肝硬化患者上消化道出血的有效性。
选取2018年1月至2020年12月在宁波市鄞州第二医院消化内科住院的84例肝硬化合并上消化道出血患者作为研究对象。将他们随机分为研究组（n = 42）和对照组（n = 42）。所有患者均给予生长抑素静脉滴注。研究组加用限制性液体复苏治疗。比较两组治疗48小时后血红蛋白（Hb）、血小板、纤维蛋白原、血细胞比容、红细胞输血量、止血时间、0 h - 24 h、24 h - 48 h及>48 h的止血率、再出血率、复苏率及并发症发生率。
发现治疗48小时后，研究组的Hb、血小板、纤维蛋白原和血细胞比容较对照组显著升高（P < 0.01）。研究组反应良好的患者比例显著高于对照组（P < 0.05）。研究组的总有效率为90.48%，显著高于对照组的71.43%（P < 0.05）。研究组的红细胞输血量低于对照组，止血时间短，再出血率低（P < 0.01）。研究组0 h - 24 h的止血率显著高于对照组（P < 0.05）。研究组>48 h的止血率低于对照组（P < 0.05）。研究组并发症的总发生率为9.52%，显著低于对照组的30.95%（P < 0.05）。
这些数据表明，生长抑素静脉滴注后进行限制性液体复苏在治疗肝硬化患者上消化道出血方面具有更好的临床疗效，考虑到复苏率和止血率更高以及并发症发生率降低，这有利于患者的康复，值得进一步临床推广。
