中国临床药理学杂志2025，Vol.41Issue(13)：1816-1821,6.DOI:10.13699/j.cnki.1001-6821.2025.13.004
凝血酶散联合奥曲肽治疗肝硬化门脉高压食管胃底静脉曲张破裂出血患者的临床研究
Clinical study of thrombin powder combined with octreotide in the treatment of patients with esophagogastric variceal bleeding of cirrhotic portal hypertension
摘要
Abstract
Objective To observe the effectiveness and safety of thrombin powder combined with octreotide in the treatment of patients with esophagogastric variceal bleeding(EGVB)of cirrhotic portal hypertension.Methods Patients with EGVB of cirrhotic portal hypertension were divided into control group and treatment group.The control group was given micro pump intravenous infusion of 0.6 mg octreotide acetate injection(once/d),while treatment group was given oral administration or gastric tube injection of 500 U thrombin powder(once every 4 h)on basis of control group.All patients were treated for 3 d.The clinical curative effect,treatment-related indexes(disappearance time of hematemesis and melena,blood transfusion volume,length of hospital stay),vital signs(heart rate,mean arterial pressure),liver function indexes[total bilirubin(TBil),glutamic-oxaloacetic transaminase(GOT),glutamic-pyruvic transaminase(GPT)]and coagulation function indexes[prothrombin time(PT),fibrin degradation product(FDP),D-dimer(D-D)]were compared between the two groups,and the safety was evaluated.Results There were 34 patients in treatment group and 34 patients in control group.After treatment,total response rates of treatment group and control group were 94.12％(32 cases/34 cases)and 76.47％(26 cases/34 cases),and the difference was statistically significant(P＜0.05).After treatment,disappearance time of hematemesis in treatment group and control group was(26.24±5.06)and(34.95±7.43)h,disappearance time of melena was(28.71±5.52)and(36.24±7.18)h,length of hospital stay was(6.86±1.53)and(8.03±1.71)d,blood transfusion volume was(3.08±0.89)and(4.51±1.13)U,heart rates were(79.41±5.06)and(90.53±6.18)beat·min-1,mean arterial pressure was(102.16±8.43)and(90.33±7.02)mmHg,TBil levels were(37.04±4.75)and(41.53±5.18)μmol·L-1,GOT levels were(68.02±7.48)and(77.63±8.25)U·L-1,GPT levels were(53.85±4.82)and(60.41±5.36)U·L-1,PT was(11.25±1.77)and(14.06±2.08)s,FDP levels were(3.41±0.86)and(5.07±1.22)mg·L-1,D-D levels were(2.06±0.54)and(3.13±0.72)mg·L-1,differences of the above indexes between the two groups were statistically significant(all P＜0.05).The main adverse drug reactions in treatment group were nausea,headache and pruritus,while which in control group were nausea,headache and gastrointestinal reactions.There was no significant difference in total incidence of adverse drug reactions between treatment group and control group[11.76％(4 cases/34 cases)vs 8.82％(3 cases/34 cases),P＞0.05].Conclusion Thrombin powder combined with octreotide can improve clinical curative effect,promote recovery of vital signs,improve liver function and coagulation function in patients with EGVB of cirrhotic portal hypertension,which has relatively high safety.关键词
凝血酶散/醋酸奥曲肽注射液/肝硬化门静脉高压/食管胃底静脉曲张破裂出血/临床疗效/肝功能/凝血功能Key words
thrombin powder/octreotide acetate injection/cirrhotic portal hypertension/esophagogastric variceal bleeding/clinical curative effect/liver function/coagulation function引用本文复制引用
程畅,付冲,桂志兵,张焰平..凝血酶散联合奥曲肽治疗肝硬化门脉高压食管胃底静脉曲张破裂出血患者的临床研究[J].中国临床药理学杂志,2025,41(13):1816-1821,6.基金项目
安徽省卫生健康科研基金资助项目(AHWJ2023BAa20028) （AHWJ2023BAa20028）
