Abstract
Objective 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. Methods 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 (n = 42) and control group (n = 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. Results 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 (P < 0.01). The proportion of patients with excellent response was notably higher in the study group than in the control group (P < 0.05). The overall response rate of the study group was 90.48%, which was significantly higher than 71.43% in the control group (P < 0.05). The study group had lower transfusion volume of red blood cells, shorter hemostatic time, and lower rebleeding rates than the control group (P < 0.01). The hemostatic rate of 0 h–24 h in the study group was remarkably higher than that in the control group (P < 0.05). The hemostatic rate of >48 h in the study group was lower than that in the control group (P < 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 (P < 0.05). Conclusion 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.
Highlights
Liver cirrhosis is one of the common severe diseases, which is mainly caused by connective tissue hyperplasia and nodular regeneration caused by diffuse liver injury
All patients and their families agreed to participate in the study, with a high degree of cooperation, with complete clinical data. ose who had any of the following conditions were excluded: administration of nonsteroidal, acid-inhibitory and anti-inflammatory drugs; severe organic diseases such as respiratory failure, heart failure, and cerebral infarction; upper gastrointestinal bleeding caused by noncirrhotic factors, such as gastrointestinal surgery and peptic ulcer; infectious disease; primary liver cancer; intolerance to gastroscopy; and mental or cognitive impairment
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 (P < 0.01; Table 1)
Summary
Liver cirrhosis is one of the common severe diseases, which is mainly caused by connective tissue hyperplasia and nodular regeneration caused by diffuse liver injury. Liver cirrhosis has been considered as an advanced liver disease that eventually leads to death in the absence of liver transplantation [2]. Liver cirrhosis is the cause of increased incidence rate and mortality rate. It is regarded as the fourteenth most common cause of death in the world, but ranked fourth in central Europe. According to different stages of disease, the one-year mortality of liver cirrhosis varies from 1% to 57% [3]
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