目的 探討注射用特利加壓素聯(lián)合注射用奧美拉唑治療肝硬化上消化道出血的臨床療效。方法 選取2015年3月—2017年3月在平煤神馬醫(yī)療集團(tuán)總醫(yī)院進(jìn)行治療的肝硬化上消化道出血患者82例為研究對象，根據(jù)用藥的差別將入組者分為對照組和治療組，每組各41例。對照組靜脈滴注注射用奧美拉唑鈉，40 mg加入到0.9%氯化鈉溶液100 mL中，2次/d，出血控制后再治療2 d。治療組在對照組基礎(chǔ)上靜脈推注注射用特利加壓素，首次劑量為2 mg，注射時(shí)間>1 min，維持劑量1～2 mg/4 h，持續(xù)24～48 h，直至出血控制，然后再治療2 d。觀察兩組的臨床療效，比較兩組的生活質(zhì)量量表（QLQ-C30）評分、血流動力學(xué)指標(biāo)、血清學(xué)指標(biāo)、止血時(shí)間、輸血量、游離肝靜脈壓（FHVP）和肝靜脈楔嵌壓（WHVP）。結(jié)果 治療后，對照組和治療組的總有效率分別為80.49%、95.12%，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組軀體、認(rèn)知、角色、社會功能評分均明顯升高，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些指標(biāo)明顯高于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組門靜脈血流、脾靜脈血流、門靜脈內(nèi)徑、脾靜脈內(nèi)徑均明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組血清超敏C反應(yīng)蛋白（hs-CRP）、皮質(zhì)醇、胰高血糖素、一氧化氮（NO）水平均明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組平均止血時(shí)間、平均輸血量均少于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組FHVP、WHVP均明顯降低，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療組這些指標(biāo)明顯低于對照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 注射用特利加壓素聯(lián)合注射用奧美拉唑治療肝硬化上消化道出血具有較好的臨床療效，可改善機(jī)體血流動力學(xué)指標(biāo)，降低血清hs-CRP、皮質(zhì)醇、胰高血糖素、NO水平，提高患者生活質(zhì)量，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Terlipressin for injection combined with Omeprazole Sodium for injection in treatment of liver cirrhosis with upper gastrointestinal bleeding. Methods Patients (82 cases) with liver cirrhosis with upper gastrointestinal bleeding in Pingdingshan Shenma Medical Group General Hospital from March 2015 to March 2017 were enrolled in this study. According to the difference treatment plan, patients were divided into control and treatment groups, and each group had 41 cases. Patients in the control group were iv administered with Omeprazole Sodium for injection, 40 mg added into normal saline 100 mL, twice daily, retreatment of 2 d after bleeding control. Patients in the treatment group were iv administered with Terlipressin for injection on the basis of the control group, first dose of 2 mg, injection time > 1 min, maintenance dose of 1-2 mg/4 h, continuous treatment of 24-48 h, until bleeding control, then retreatment of 2 d. After treatment, the clinical efficacies were evaluated, and QLQ-C30 scores, hemodynamic indexes, serological indexes, hemostasis time, blood transfusion volume, free hepatic venous pressure (FHVP), and hepatic vein wedge pressure (WHVP) in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 80.49% and 95.12%, respectively, and there was difference between two groups (P < 0.05). After treatment, the scores of body, cognition, role, and social function in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly higher than those in the control group, with significant difference between two groups (P < 0.05). After treatment, portal vein blood flow, splenic vein blood flow, portal vein diameter, and splenic vein diameter in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of hs-CRP, cortisol, glucagon, and NO in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the average hemostasis time and average blood transfusion volume in the treatment group were significantly less than those in the control group, and there was difference between two groups (P < 0.05). After treatment, FHVP and WHVP in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Terlipressin for injection combined with Omeprazole Sodium for injection has clinical curative effect in treatment of liver cirrhosis with upper gastrointestinal bleeding, can improve the hemodynamics indexes, reduce the levels of serum hs-CRP, cortisol, pancreatic glucagon, and NO, improve the quality of life, which has a certain clinical application value.