Value of clinical pathway in the management of adverse effects of terlipressin in the treatment of cirrhosis complicated with bleeding from esophageal varices or gastric varices

Objective To investigate the value of clinical path in the management of adverse effects of terlipressin for cirrhosis complicated with Bleeding from esophageal varices (EVs) or gastric varices (GVs). Methods Seventy-two cases of cirrhosis with bleeding from esophageal varices or gastric varices received terlipressin in our hospital between December, 2015 and December, 2016, and were divided into observational group (n=38) and normal group (n=34) randomly. The observational group was managed by clinical path, whereas the normal group received the conventional measures. The incidence of adverse effects related to terlipressin, treatment compliance, nursing satisfaction index and bleeding control in one week were compared between the two groups. The differences about the four aforementioned parameters were statistically analyzed. Results The incidence of adverse effects (abdominal pain, diarrhea, increased blood pressure, bradycardia and hyponatremia) in the observational group was similar to those in the normal group (44.7% vs. 44.1%, P>0.05); while treatment compliance, nursing satisfaction and bleeding control were all higher than those in the normal group significantly (97.4% vs. 82.4%, 89.5% vs. 70.6%, and 100% vs. 85.3%), respectively, the difference was statistical significant, P<0.05. Conclusion The adverse effects of terlipressin in the treatment of cirrhosis with esophageal and gastric variceal bleeding are relatively common. Clinical path intervention fails to reduce the incidence of those adverse effects, but can improve treatment compliance and nursing satisfaction of the patients, thus benefits the early control of bleeding significantly.