生长抑素联合奥美拉唑治疗重度非静脉曲张性上消化道出血临床观察

The clinical observation of Somatostatin combined with Omeprazole in the treatment of severe non-variceal upper gastrointestinal bleeding

目的观察生长抑素联合奥美拉唑钠(商品名:洛赛克)治疗重度非静脉曲张性上消化道出血的临床疗效。方法重度非静脉曲张性上消化道出血患者135例,按随机数字表法分为三组。常规剂量生长抑素组35例,采用常规生长抑素剂量(6 mg/d)联合注射用奥美拉唑钠治疗;大剂量生长抑素组30例,采用2倍剂量生长抑素(12 mg/d)联合注射用奥美拉唑钠治疗;对照组70例,给予注射用奥美拉唑钠治疗。比较三组治疗的止血率、血红蛋白下降程度及平均住院时间。结果常规剂量和大剂量生长抑素组入院后第12、24、48小时的止血率均高于对照组(P<0.01),且大剂量生长抑素组止血率高于常规剂量生长抑素组(P<0.05),第72小时止血率三组比较差异无统计学意义(P>0.05);常规剂量和大剂量生长抑素组血红蛋白下降程度均低于对照组(P<0.01),且大剂量生长抑素组低于常规剂量生长抑素组(P<0.05);常规剂量和大剂量生长抑素组平均住院时间均短于对照组(P<0.05)。结论生长抑素联合奥美拉唑钠治疗重度非静脉曲张性上消化道出血具有止血迅速、住院时间短、失血量少等优点,且2倍剂量生长抑素的临床疗效更佳。

Objective To investigate the clinical efficacy of Somatostatin combined with Omeprazole（ Trade names：Losec） for severe non-variceal upper gastrointestinal bleeding. Methods 135 patients with severe non-variceal upper gastrointestinal bleeding were randomly divided into three groups：Conventional close intravenous injection of Somatostatin （6 mg/day） combined with Omeprazole group of patients （ n = 35 ） ; Large doses intravenous injection of Somatostatin （ 12 rag/day） combined with Omeprazole intravenous in- jection group of patients（ n = 30） ; Control group intravenous injection of Omeprazole only（ n = 70）. The difference of hemostatic rate, level of hemoglobin descent and the average length of hospital stay of three groups were analyzed. Results Hematostatie rate of two So- matostatin groups were higher than the control group in 12 hours, 24 hours and 48 hours after admission （P 〈 0.01 ） , and large dose Somtostatin group was higher than conventional close Somtostatin（ P 〈 0.05 ）. But in 72 hours after admission, no difference of hemato- static rate were found in three groups（P 〉 0.05）. Level of hemoglobin descent in two Somatostatin groups were lower than the control group （P 〈 0.01 ）, and large dose Somtostatin group was better than conventional dose Somtostatin group （P 〈 0.05 ）. The average length of hospital stay in two Somatostatin group were shorter than control group （ P 〈 0.05 ）. Conclusion The Somatostatin combined Ome- prazole rapidly stop bleeding, had shorter hospital stay, and less blood loss in the treatment of severe non-variceal upper gastrointestinal bleeding. There was close-effect relationship in the therapeutic effect of Somatostatin.