| The first part:terlipressin applied in patients with Esophage al and gastric variceal bleedingObjective:To observe the clinical efficacy of terlipressin in patients with esophageal and gastric variceal bleeding,and to evaluate the efficacy and safety of treatment.Method:A retrospective analysis of the First Affiliated Hospital of Kunming Medical University,department of infectious diseases in September 2016-March 2017 in hospital patients of esophageal variceal bleeding 30 cases,according to whether the use of terpressin to be divided into two groups,12 cases in observation group and 18 cases in the control group.The two groups were treated with fasting,drinking,oxygen,infusion,blood volume and other basic treatment,the observation group on this basis plus terpressin(2mg/4h,bleeding stopped to 2 times/d,lmg/Day,continuous use 5d),the control group to somatostatin(the first dose of 250ug intravenous injection,follow-up 250ug/h continuous pumping,continuous use 5d),observed and compared the two groups of treatment and recovery.The two groups were treated with fasting,drinking,oxygen,infusion,blood volume and other basic treatment,the observation group on this basis plus terpressin(2mg/4h,bleeding stopped to 2 times/d,lmg/day,continuous use 5d),the control group was treated with somatostatin(the first dose of 250ug intravenous injection,follow-up 250ug/h continuous pumping,continuous use 5d),observed and compared the treatment and recovery of two groups.Results:There was no significant difference in gender composition,age,liver and kidney function,esophageal variceal grade and Child-Pugh grade(P>0.05).The hemostasis time of the two groups was 15.7±1.9h?21.9±3.5h,the difference was statistically significant(P<0.05),The number of successful hemostasis was 11 cases(91.6%),16 cases(88,9%),the number of rebleeding was 1 case(8.3%)and 2 cases(11.1%),the difference was not statistically significant(P>0.05).Compared with the day of admission,the diameter of portal vein and splenic vein were reduced in two groups,but the improvement was obvious in the observation group.The diameter ofportal vein and splenic vein were 11.1±1.0mm and 8.1±0.8mm in the observation group.The diameter of portal vein and splenic vein were 12.1±0.9mm and 9.2±0.9mm in the control group,the difference was statistically significant(P<0.05).Conclusion:In the treatment of esophageal and gastric variceal bleeding,terlipressin is better than somatostatin in the hemostasis time,there is no significant difference between hemostatic rate and rebleeding rate,terpressin is better than somatostatin in improving the diameter of portal vein and splenic vein,it has a significant effect on lowering portal pressure.The second part:Protective effects of terlipressin on liver and renal function in patients after hepatectomyObjective:To observe the clinical efficacy of terlipressin in patients after hepatectomy,to explore its protective effect on liver and kidney function after hepatectomy,and to evaluate the efficacy and safety of treatment.Method:A retrospective analysis of organ transplantation,the First Affiliated Hospital of Kunming Medical University,March 2016-March2017 for hepatectomy in the treatment of primary hepatocellular carcinoma patients in 48 cases,according to whether it was treated with terlipressin was divided into observation group 20 cases and the control group 28 cases,two groups were treated with hepatoprotective,diuretic,supplement of albumin,improve microcirculation of such treatment,the observation group based on the use of terlipressin(2mg/d continuous infusion,continuous use of 5d),to observe the changes of clinical parameters before and after treatment between the two groups.Results:There was no significant difference between the two groups in gender composition,age,liver and kidney function level,Child-Pugh grade,tumor size,intraoperative conditions and other general information(P>0.05);Compared with the first day after operation,the liver and kidney function of the two groups,24h urine output and intraperitoneal drainage volume were improved in the 3 and 5 day after operation,and the improvement of the observation group was significant compared with the control group.Compared with the control group,the liver and kidney function of observation group in the 3 and 5 day after operation were ALT 112.66±11.6 U/L,39.9±4.1U/L,AST 118.1±7.6U/L,45.414.5U/L,Tbil 19.9±1.9umol/L,11.0±2.3umol/L,BUN 7.3±1.0mmol/L,6.2±10.7mmol/L,Scr 72.4±3.5umol/L,63.8±2.6umol/L;the liver and kidney function of control group in the 3 and 5 day after operation were ALT 122.5±10.6U/L,50.8±3.8U/L,AST 126.3±3.3U/L,49.0±4.9U/L,Tbil 21.3± 1.6umol/L,12.7±2.5umol/L,BUN 7.8±0.7mmol/L,7.1±0.8mmol/L,Scr 76.1±6.5umol/L,69.3±5.4umol/L,there were significant differences between two groups(P<0.05).The 24h urine volume of observation group in the 3 and 5 day after operation were 2102.5±142.8ml,2252.8±152.4ml;The 24h urine volume of control group in the 3 and 5 day after operation were 1964.31131.8ml,2092.9±103.4ml,there were significant differences between two groups(P<0.05).The peritoneal drainage of observation group in the 3 and 5 day after operation were 113.0±8.6ml,35.8±18.8ml;the peritoneal drainage ratio of control group in the 3 and 5 day after operation were 131.1 ± 12.9ml,43.9±9.8ml,there were significant differences between two groups(P<0.05).The abdominal drainage time and hospitalization time of observation group.were 5.1 ±0.8d,7.8±1.2d,the abdominal drainage time and hospitalization time of control group were 6.61±1.1d,10.9±1.0d,there were significant differences between two groups(P<0.05).Conclusion:Terlipressin can reduce the progressive impairment of liver function after hemihepatectomy,reduce ascites formation,improve renal function,shorten drainage time and hospitalization time,improve the perioperative safety,It combines the principles of rapid rehabilitation surgery. |
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