| 董胜肖,靳海峰,刘惠敏,刘文格,姚 欣.肠道益生菌联合奥曲肽对肝硬化合并胃食管静脉曲张初次出血患者血流动力学及预后的影响[J].,2018,(24):4752-4755 |
| 肠道益生菌联合奥曲肽对肝硬化合并胃食管静脉曲张初次出血患者血流动力学及预后的影响 |
| Effect of Enteric Probiotics Combined with Octreotide on Hemodynamics and Prognosis in Patients with Cirrhosis Combined with Gastroesophageal Varicosity Primary Hemorrhage |
| 投稿时间：2018-06-15 修订日期：2018-07-12 |
| DOI：10.13241/j.cnki.pmb.2018.24.034 |
| 中文关键词: 肝硬化 胃食管静脉曲张 肠道益生菌 奥曲肽 血流动力学 预后 |
| 英文关键词: Liver cirrhosis Gastroesophageal varicosity Enteric probiotics Octreotide Hemodynamics Prognosis |
| 基金项目:河北省2018年度医学科学研究重点课题（20170205） |
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| 中文摘要: |
| 摘要 目的：研究肠道益生菌联合奥曲肽对肝硬化合并胃食管静脉曲张初次出血患者血流动力学及预后的影响。方法：选取2016年5月-2017年4月我院收治的肝硬化合并胃食管静脉曲张初次出血患者96例，以随机数字表法分成研究组（n=48）和对照组（n=48）。对照组予以奥曲肽治疗，研究组则采用肠道益生菌联合奥曲肽治疗，疗程均为28天。分别比较两组临床治疗总有效率、再出血率、病死率、临床症状改善时间、止血时间以及住院时间，观察并比较治疗前后血流动力学、血清内皮素（ET）、一氧化氮（NO）、内毒素脂多糖（LPS）水平。结果：研究组临床治疗总有效率为93.75%（45/48），高于对照组的79.17%（38/48）（P<0.05）。治疗后两组患者心输出量（CO）、心脏指数（CI）、门静脉血流量（PVF）、食管曲张静脉变化（EVD）均较治疗前降低，且研究组低于对照组（P<0.05）。治疗后两组患者血清ET、NO、LPS水平均较治疗前降低，且研究组低于对照组（P<0.05）。与对照组比较，研究组再出血率、临床症状改善时间、止血时间以及住院时间均降低（P<0.05），而两组病死率比较差异无统计学意义（P>0.05）。结论：肠道益生菌联合奥曲肽治疗肝硬化合并胃食管静脉曲张初次出血患者的临床疗效明显，能够改善患者血流动力学和促进肠道菌群的平衡，预后较佳。 |
| 英文摘要: |
| ABSTRACT Objective: To study the effect of enteric probiotics combined with octreotide on hemodynamics and prognosis in pa- tients with liver cirrhosis combined with gastroesophageal varicosity primary hemorrhage. Methods: 96 cases of liver cirrhosis combined with gastroesophageal varicosity primary hemorrhage who were treated in our hospital from May 2016 to April 2017 were selected. The patients were divided into the study group(n=48) and the control group(n=48) by random digital table method. The control group was treated with octreotide, and the study group was treated with enteric probiotics combined with octreotide, the course of treatment was 28 d. The total effective rate, rebleeding rate, fatality rate, clinical symptom improvement time, hemostasis time and hospitalization time were compared between the two groups, hemodynamics, serum endothelin(ET), nitric oxide(NO) and endotoxin lipopolysaccharide (LPS) levels were observed and compared before and after treatment. Results: The total effective rate of clinical treatment in the study group was 93.75% (45/48), which was higher than 79.17% (38/48) of the control group(P<0.05). Cardiac output(CO), cardiac index (CI), portal ve- nous blood flow(PVF) and esophageal varices (EVD) in the two groups after treatment were all lower than those before treatment, and the study group was lower than that in the control group(P<0.05). The levels of serum ET, NO and LPS in the two groups after treatment were lower than those before the treatment, and the study group was lower than the control group(P<0.05). Compared with the control group, the rebleeding rate, the time of improvement of clinical symptoms, the time of hemostasis and the time of hospitalization in the study group were all decreased(P<0.05), but there was no statistically significant difference in fatality rate between the two groups by sta- tistical analysis(P>0.05). Conclusion: Enteric probiotics combined with octreotide in the treatment of liver cirrhosis combined with gas- troesophageal varicosity primary hemorrhage is effective. It can improve the hemodynamics and promote the balance of intestinal flora, and has better prognosis. |
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