Efficacy of octreotide combined with thrombin in treating upper gastrointestinal bleeding in cirrhotic patients

Yan Ya; Chen Junxu; Zhang Mingguang

doi:10.3969/j.issn.1672-8157.2025.06.020

Abstract：Objective To explore the efficacy of octreotide combined with thrombin in treating upper gastrointestinal bleed-ing in cirrhotic patients and its influence on the liver function and quality of life of patients.Methods A total of 80 patients with liver cirrhosis and upper gastrointestinal bleeding admitted to West China Hospital of Sichuan University from January 2021 to January 2025 were included as the subjects of this trial and divided into a monotherapy group(40 cases,receiving thrombin in ad-dition to standard treatment)and a combined therapy group(40 cases,receiving both thrombin and octreotide alongside standard treatment).The clinical efficacy,hemostasis time,symptom improvement time,blood transfusion volume,complication rates,liver function indicators and quality of life(Short Form-36 Health Survey(SF-36))before and after treatment were compared and ana-lyzed between the two groups.Patients in the two groups were followed up for 1 months to observe the recurrence bleeding rate.Results The total effective rate of the combined group was 95.00%(38/40),which was higher than that of control group(80.00%(32/40)),and the difference was statistically significant(χ2=4.114,P<0.05).The hemostasis time,symptom improvement time and blood transfusion volume in the combined group((16.92±3.65)h,(1.29±0.48)d,(308.52±21.25)mL,respectively)were all lower than those in the monotherapy group((22.53±2.9)h,(2.15±0.69)d,(396.23±34.23)mL),and the differences were statistically sig-nificant(t=7.581,6.471,13.768,all P<0.05).The complication rate of the combined group(5.00%(2/40))was lower than that of the control group(25.00%(10/40)),and the difference was statistically significant(OR(95%CI)6.33(1.26-31.8),P=0.032).After the treatment,the levels of total bilirubin,alanine aminotransferase,and aspartate aminotransferase in the combined group((31.95±4.92)μmol·L-1,(41.95±6.23)U·L-1,(36.94±6.52)U·L-1,respectively)were all lower than those in the monotherapy group((44.23±5.23)μmol·L-1,(70.45±7.2)U·L-1,(51.65±8.72)U·L-1),and the SF-36 score of the combined group((70.54±2.85)points)was higher than that of the monotherapy group((65.23±4.12)points),and the differences were statistically significant(t=8.545,18.886,10.816,6.704,all P<0.001).The rebleeding rate in the combined group(2.50%(1/40))was lower than that in the mono-therapy group(17.50%(7/40)),and the difference was statistically significant(χ2=4.675,P<0.05).Conclusion The combination of octreotide and thrombin demonstrates a good therapeutic efficacy in treating upper gastrointestinal bleeding in cirrhotic patients,improving the liver function,reducing the complication rate,enhancing the condition of patients,improving the quality of life,and lowering the incidence of rebleeding.