持续静脉输注奥美拉唑联合生长抑素治疗急性非静脉曲张性上消化道大出血的疗效

Efficacy of continuous intravenous infusion of omeprazole combined with somatostatin in treatmeat for acute nonvariceal upper gastrointestinal heavy bleeding

目的观察持续静脉输注奥美拉唑联合生长抑素治疗急性非静脉曲张性上消化道大出血的疗效。方法将63例急性非静脉曲张性上消化道大出血患者随机分为治疗组(33例)和对照组(30例),治疗组给予生长抑素250μg首剂静推,继之以250μg/h持续静脉泵入,奥美拉唑80 mg首次静脉滴注,继之以8 mg/h持续静脉泵入;对照组给予奥美拉唑80 mg首次静脉滴注,继之40 mg静脉滴注,2次/d。结果治疗组的止血显效率为66.7%,明显高于对照组43.3%,P<0.01;治疗组的平均止血时间为(22.46±6.38)h,短于对照组(30.52±7.23)h,P<0.05;治疗组的再出血率为13.3%,低于对照组34.8%,P<0.05。结论持续静脉输注奥美拉唑联合生长抑素与单用奥美拉唑间歇静脉滴注相比,在治疗急性非静脉曲张性上消化道大出血中更有效。

Objective To observe the efficacy of continuous intravenous infusion of omeprazole combined with somatostatin in the treatmeat for acute nonvariceal upper gastrointestinal heavy bleeding.Methods 63 patients with acute nonvariceal upper gastrointestinal heavy bleeding were randomized divided into treatment group（n=33）and control group（n=30）.Patients in treatment group received somatostatin 250 μg i.v.and then continuous intravenous pump at a rate of 250 μg/h,and were given intravenous omeprazole 80 mg first,then continuous intravenous pump at a rate of 8 mg/h.Patients in control group were given intravenous omeprazole 80 mg first,and 40 mg twice a day.Results The effective rate of hemostasis in treatment group was 66.7%,much higher than that in control group（43.3%,P0.01）;The time of hemostasis in treatment group was（22.46±6.38）h,shorter than that in control group[（30.52±7.23）h,P0.05];The rate of rebleeding in treatment group was 13.3%,less than that in control group（34.8%,P0.05）.Conclusion Continuous intravenous infusion of omeprazole combined with somatostatin is more effective than intermittent intravenous infusion of omeprazole in controlling acute nonvariceal upper gastrointestinal heavy bleeding.