CAJ | 학술논문

目的：评价奥曲肽联合特利加压素治疗肝硬化的疗效及对患者肝静脉压力梯度的影响，探讨其临床适用性。方法：选择68例肝硬化合并静脉曲张破裂出血患者，将其随机分为观察组与对照组，每组34例，对照组予奥曲肽静脉给药治疗，观察组予奥曲肽联合特利加压素静脉给药治疗。观察两组用药前及治疗1 min、5 min、10 min、15 min、25 min以及35 min后患者的肝静脉锲入压(WHVP)、肝静脉游离压(FHVP)和肝静脉压力梯度(HVPG)指标的变化情况。结果：①治疗1 min后，两组患者的WHVP均显著升高，差异有统计学意义(t=0.6868，P＜0.05)，观察组治疗25 min后WHVP指标均显著高于对照组，差异有统计学意义(t=2.0877，P＜0.05)；②治疗1 min后两组患者的FHVP均显著升高，差异有统计学意义(t=0.9159，P＜0.05)。观察组患者在25 min后FHVP指标均显著高于对照组患者，差异均有统计学意义(t=2.0570，P＜0.05)。观察组患者在25 min后HVPG高于对照组，差异有统计学意义(t=5.4954，P＜0.05)。结论：奥曲肽给药后，联合特利加压素可显著降低肝静脉压力梯度的力度，起到更好的降低门静脉压力作用，适合临床推广应用。
목적：평개오곡태연합특리가압소치료간경화적료효급대환자간정맥압력제도적영향，탐토기림상괄용성。방법：선택68례간경화합병정맥곡장파렬출혈환자，장기수궤분위관찰조여대조조，매조34례，대조조여오곡태정맥급약치료，관찰조여오곡태연합특리가압소정맥급약치료。관찰량조용약전급치료1 min、5 min、10 min、15 min、25 min이급35 min후환자적간정맥계입압(WHVP)、간정맥유리압(FHVP)화간정맥압력제도(HVPG)지표적변화정황。결과：①치료1 min후，량조환자적WHVP균현저승고，차이유통계학의의(t=0.6868，P＜0.05)，관찰조치료25 min후WHVP지표균현저고우대조조，차이유통계학의의(t=2.0877，P＜0.05)；②치료1 min후량조환자적FHVP균현저승고，차이유통계학의의(t=0.9159，P＜0.05)。관찰조환자재25 min후FHVP지표균현저고우대조조환자，차이균유통계학의의(t=2.0570，P＜0.05)。관찰조환자재25 min후HVPG고우대조조，차이유통계학의의(t=5.4954，P＜0.05)。결론：오곡태급약후，연합특리가압소가현저강저간정맥압력제도적력도，기도경호적강저문정맥압력작용，괄합림상추엄응용。
Objective:To evaluate the effects of the combination of octreotide and terlipressin on hepatic venous pressure gradient in cirrhotic patients, and to explore its clinical applicability.Methods: 68 acute variceal bleeding in cirrhotic patients were selected from January 2012 to January 2015, and they were simple randomly divided into the control group and the experimental, 34 cases in each group, and the control group were only given octreotide, while the experimental group were given the combination of octreotide, and measured the WHVP, FHVP, HVPG before drugs and at 1min, 5min,10min,15 min,25 min,35 min.Results:1)After 1min treatment the two groups of patients with WHVP were significantly higher(t=0.6868,P<0.05), And WHVP in the test group patients after 25min were significantly higher than those of patients in the control group, the difference was statistically significant (t=2.0877,P<0.05). 2)After 1min treatment the two groups of patients with FHVP were significantly higher, the differences were statistically significant (t=0.9159,P<0.05), And the test group patients in 25min after FHVP were significantly higher than those of patients in the control group, the difference was statistically significant (t=2.0570,P<0.05). After 1min treatment the two groups of patients with HVPG were significantly higher, the differences were statistically significant (t=5.4954,P<0.05).Conclusions: Octreotide administration, combined with terlipressin can significantly reduce the hepatic venous pressure gradient force, play a better function of decreasing portal vein pressure, suitable for long-term clinical application.