生长抑素联合不同剂量耐信对消化道出血临床疗效及安全性的影响

Study on the clinical efficacy and safety of somatostatin combined with different doses of nexium in patients with gastrointestinal bleeding

[目的]观察生长抑素联合大剂量耐信在消化道出血中的临床疗效及安全性。[方法]选取2016-08—2018-12治疗的123例消化道出血患者,按照随机数字表法分为大剂量组、常规剂量组和对照组,每组41例。对照组患者给予生长抑素,常规剂量组在对照组基础上给予常规剂量的艾司奥美拉唑(耐信),大剂量组在对照组基础上给予大剂量的艾司奥美拉唑。比较3组患者的疗效、24 h及48 h止血率、止血时间、住院时间、30 d内再出血率及不良反应发生率。[结果]大剂量组、常规剂量组及对照组的有效率分别为95.12%、80.49%和75.61%,3组有效率比较差异有统计学意义(χ~2=6.210,P=0.045),大剂量组有效率高于常规剂量组和对照组。大剂量组、常规剂量组及对照组的24 h止血率分别为63.41%、43.90%及36.50%,48 h止血率分别为90.24%、60.98%及49.78%,3组24 h及48 h止血率比较差异有统计学意义(χ~2=13.14,P=0.001;χ~2=16.760,P=0.000),大剂量组的24 h及48 h止血率均高于常规剂量组和对照组。大剂量组止血时间及住院时间均短于常规剂量组(t=12.753,P=0.000;t=13.213,P=0.000)。3组患者的30 d内再出血率及不良反应发生率比较差异无统计学意义(χ~2=1.520,P=0.467;χ~2=0.300,P=0.859)。[结论]生长抑素联合大剂量耐信在消化道出血中的治疗中具有良好的临床疗效,可显著减少出血量,缩短出血时间且不良反应小。

[Objective]Clinical efficacy and safety of somatostatin combined with high dose nexium in patients with gastrointestinal bleeding.[Methods]A total of 123 patients with gastrointestinal hemorrhage were selected from Aug.2016 to Dec.2018.According to the random digital table method,123 patients were divided into three groups:high dose group,routine dose group and control group,41 cases in each group.Somatostatin was given to the patients in the control group,nexium was given to the routine dose group on the basis of the control group,and nexium was given to the high dose group on the basis of the control group.The curative effect,hemostasis rate,hemostatic time,hospitalization time,rebleeding rate and adverse reaction rate in 30 days were compared between the there groups.[Results]The effective rates of high dose group,routine dose group and control group were 95.12%,80.49%and 75.61%,respectively.There are differences in the effective rate among the three groups(χ~2=6.210,P=0.045).The effective rate of high dose group was higher than that of routine dose group and control group.The 24 hour hemostatic rates of high dose group,routine dose group and control group were 63.41%,43.90%and 36.50%,respectively.The 48-hour hemostatic rates in the high-dose group,the conventional dose group and the control group were 90.24%,60.98%and 49.78%,respectively.Differences in hemostatic rate between 24 and 48 hours in the three groups(χ~2=13.14,P=0.001;χ~2=16.760,P=0.000).The hemostatic rate of high dose group at 24 hours and 48 hours was higher than that of routine dose group and control group.The hemostasis time and hospitalization time of high dose group were shorter than that of routine dose group(t=12.753,P=0.000;t=13.213,P=0.000).There was no difference in the rate of rebleeding and adverse reactions among the three groups within 30 days(χ~2=1.520,P=0.467;χ~2=0.300,P=0.859).[Conclusion]The combination of somatostatin and high dose of nexium in the treatment of gastrointestinal hemorrhage has a good clinical effect,can significantly reduce the amount of bleeding,shorten the bleeding time of patients,and the adverse reaction is low.