scholarly journals Effect of a combination of omeprazole and high-dose proton pump inhibitors on the treatment of patients with liver cirrhosis complicated with upper gastrointestinal hemorrhage

2021 ◽  
Vol 20 (10) ◽  
pp. 2143-2148
Author(s):  
Qiang Chi ◽  
Zhiqiang Lv ◽  
Wenjuan Song
Keyword(s):  
Liver Cirrhosis ◽  
Liver Function ◽  
Gastrointestinal Hemorrhage ◽  
Adverse Reactions ◽  
Control Group ◽  
High Dose ◽  
Study Group ◽  
Upper Gastrointestinal Hemorrhage ◽  
Vas Scores ◽  
Upper Gastrointestinal

Purpose: To determine the effect of a combination of omeprazole and high-dose proton pump inhibitor (PPI) on the treatment of patients with liver cirrhosis complicated with upper gastrointestinal hemorrhage.Methods: A total of 100 patients with liver cirrhosis and upper gastrointestinal hemorrhage who were admitted to Qingdao Chengyang District People’s Hospital from January 2019 to September 2020 were matched and randomly assigned to a control group and a study group. Patients in both groups received a high-dose PPI treatment, while those in the study group were given omeprazole in addition to highdose PPI. Total treatment effectiveness, incidence of adverse reactions, bleeding volume, hemostasis time, liver function after treatment, Quality of Life Index (QLI) scores, Visual Analogue Scale (VAS) scores, and bleeding (%) at 1, 2 and 4 weeks after treatment were compared for the two groups of patients.Results: Omeprazole-PPI combination produced a much more favorable outcome than treatment with only high-dose PPI, in terms of effectiveness, QLI scores and liver function (p < 0.05). The study group had significantly lower incidence of adverse reactions, bleeding volume, VAS scores, and degree of bleeding at 1, 2 and 4 weeks after treatment, as well as shorter hemostasis time, than the control group (p < 0.05).Conclusion: A combination treatment of omeprazole and high-dose PPI produces better therapeutic effect than high-dose PPI alone, in patients with liver cirrhosis and upper gastrointestinal hemorrhage.

scholarly journals Effect of cold upon upper gastrointestinal hemorrhage resulting from liver cirrhosis and its mechanism

1998 ◽  
Vol 4 (2) ◽  
pp. 80 ◽  
Author(s):  
Zhao-Zhong Li ◽  
Cheng-Dong Wei ◽  
Yao Wang ◽  
Cong Xing ◽  
Hong Guo ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Gastrointestinal Hemorrhage ◽  
Upper Gastrointestinal Hemorrhage ◽  
Upper Gastrointestinal

scholarly journals Intravenous Drip of Somatostatin Followed by Restricted Fluid Resuscitation to Treat Upper Gastrointestinal Bleeding in Patients with Liver Cirrhosis

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xuni He ◽  
Zhuhua Dai ◽  
Peina Shi ◽  
Jiemin Hong
Keyword(s):  
Liver Cirrhosis ◽  
Gastrointestinal Bleeding ◽  
Fluid Resuscitation ◽  
Blood Cells ◽  
Upper Gastrointestinal Bleeding ◽  
Control Group ◽  
Study Group ◽  
Intravenous Drip ◽  
Transfusion Volume ◽  
Upper Gastrointestinal

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.

scholarly journals Endotherapy for Nonvariceal Upper Gastrointestinal Hemorrhage

2021 ◽  
Vol 12 (02) ◽  
pp. 078-092
Author(s):  
Chhagan L. Birda ◽  
Antriksh Kumar ◽  
Jayanta Samanta
Keyword(s):  
Gastrointestinal Hemorrhage ◽  
Surgical Intervention ◽  
Thermal Therapy ◽  
Upper Gastrointestinal Hemorrhage ◽  
Transfusion Strategy ◽  
Related Factors ◽  
Primary Hemostasis ◽  
Mechanical Therapy ◽  
Definitive Management ◽  
Upper Gastrointestinal

AbstractNonvariceal upper gastrointestinal hemorrhage (NVUGIH) is a common GI emergency with significant morbidity and mortality. Triaging cases on the basis of patient-related factors, restrictive blood transfusion strategy, and hemodynamic stabilization are key initial steps for the management of patients with NVUGIH. Endoscopy remains a vital step for both diagnosis and definitive management. Multiple studies and guidelines have now defined the optimum timing for performing the endoscopy after hospitalization, to better the outcome. Conventional methods for achieving endoscopic hemostasis, such as injection therapy, contact, and noncontact thermal therapy, and mechanical therapy, such as through-the-scope clips, have reported to have 76 to 90% efficacy for primary hemostasis. Newer modalities to enhance hemostasis rates have come in vogue. Many of these modalities, such as cap-mounted clips, coagulation forceps, and hemostatic powders have proved to be efficacious in multiple studies. Thus, the newer modalities are recommended not only for management of persistent bleed and recurrent bleed after failed initial hemostasis, using conventional modalities but also now being advocated for primary hemostasis. Failure of endotherapy would warrant radiological or surgical intervention. Some newer tools to optimize endotherapy, such as endoscopic Doppler probes, for determining flow in visible or underlying vessels in ulcer bleed are now being evaluated. This review is focused on the technical aspects and efficacy of various endoscopic modalities, both conventional and new. A synopsis of the various studies describing and comparing the modalities have been outlined. Postendoscopic management including Helicobacter pylori therapy and starting of anticoagulants and antiplatelets have also been outlined.

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