奥美拉唑联合奥曲肽治疗非静脉曲张性上消化道出血的临床观察

Clinical observation on omeprazole combined with octreotide in treatment of non-variceal upper gastrointestinal hemorrhage

目的观察并探讨奥美拉唑联合奥曲肽治疗非静脉曲张性上消化道出血的临床疗效。方法选取2009年2月～2012年3月88例上消化道大出血患者,并随机单盲分为观察组(45例)与对照组(43例),对照组给予抗休克、抗感染、奥美拉唑及凝血酶治疗,观察组在对照组基础上予奥曲肽止血,记录并观察两组患者止血时间与临床疗效。结果 (1)观察组与对照组平均止血时间分别为(32.8±4.8)、(35.1±5.4)h,差异具有统计学意义(P=0.038);(2)观察组与对照组48h内止血效果构成不同(P=0.042),两组显效率与总有效率分别为55.6%、91.1%和37.2%、76.7%;(3)两组治疗期间均未见明显不良反应。结论奥美拉唑联合奥曲肽治疗非静脉曲张性上消化道大出血可提高止血效率与效果,具备一定临床推广价值。

Objective To observe and investigate the clinical efficacy of omeprazole in combination with octreotide in the treatment of non-variceal upper gastrointestinal bleeding. Methods Eighty-eight patients with massive upper gastrointestinal bleeding from February 2009 to March 2012 were selected and randomly divided into the single-blind observation group （45 patients） and the single-blind control group （43 patients）. The control group was given antishock, anti-inflammatory, omeprazole and thrombin treatment and the observation group was given additional octreotide hemostasis treatment on the basis of the control group. The hemostasis time and clinical efficacy of the two groups were recorded and observed. Results （1）The average hemostatis time of the observation group and the control group was （32.8＋4.8） hours and （35.1＋5.4） hours respectively, with statistically significant difference （P = 0.038）; （2）The constitution of hemostatic effect within 48 hours of the observation group and the control group was different （P = 0.042）, and the markedly effective rates and the total effective rates of the two groups were 55.6%, 91.1% and 37.2%, 76.7% respectively; （3）No significant adverse reactions were observed during the treatment in either group. Conclusion In the treatment of non-variceal upper gastrointestinal bleeding, omeprazole in combination with octreotide can im- prove the hemostatic efficiency and effect, thereby of certain clinical promotion value.