泮托拉唑联合血凝酶治疗上消化道出血的临床观察

Clinical Observation of Pantoprazole Combined with Thrombin for Upper Gastrointestinal Bleeding

目的:观察泮托拉唑联合血凝酶治疗上消化道出血的临床疗效和安全性。方法:80例上消化道出血患者按随机数字表法均分为观察组和对照组。两组患者均给予卧床休息、禁饮禁食、胃肠减压、抑制胃酸、补充血容量等常规治疗。在此基础上,对照组患者给予泮托拉唑40 mg加入0.9%氯化钠注射液100 ml中静脉滴注,bid;观察组患者在对照组治疗的基础上给予血凝酶2 U静脉注射,bid。两组患者疗程均为5 d。观察两组患者的止血疗效、有效止血时间、平均输血量、治疗前后血红蛋白水平及不良反应发生情况。结果:治疗后观察组患者总有效率显著高于对照组,有效止血时间显著短于对照组,平均输血量显著低于对照组,两组比较差异均有统计学意义(P<0.05)。治疗前两组患者血红蛋白水平比较,差异无统计学意义(P>0.05);治疗后两组患者血红蛋白水平均显著高于同组治疗前,差异有统计学意义(P<0.05),但两组间比较差异无统计学意义(P>0.05)。两组患者治疗期间均未见明显不良反应发生。结论:泮托拉唑联合血凝酶治疗上消化道出血疗效显著,安全性较好。

OBJECTIVE： To observe clinical efficacy and safety of pantoprazole combined with thrombin for upper gastrointestinal bleeding. METHODS： 80 patients with upper gastrointestinal bleeding were randomly divided into observation group and control group. Both groups were given conventional symptomatic treatment, such as bed rest, fasting and water-deprivation, gastrointestinal decompression, inhibiting gastric acid, blood volume supplement. Control group was given pantoprazole 40 mg added into 0.9% Sodium chloride injection 100 ml intravenously twice a day; observation group was additionally given thrombin 2 U intrave nously twice a day on the basis of control group. Treatment course of 2 groups lasted for 5 days. Clinical efficacy of 2 groups were observed, and hematischesis effect, the time of effective hematischesis, amount of blood transfusion as well as hemoglobin and the occurrence of ADR were observed in 2 groups. RESULTS： The total effective rate of observation group was significantly higher than that of control group; effective hemostatic time was significantly shorter than that of control group; mean amount of blood transfusion was significantly lower than that of control group; there was statistical significance （P〈0.05） ; there was no statistical significance in the level of hemoglobin between 2 groups before treatment （P〉0.05）; those of 2 groups after treatment were significantly higher than before; there was statistical significance （P〈0.05） ; there was no statistical significance （P〉0.05）. No obvious ADR was found in 2 groups during treatment. CONCLUSIONS： Pantoprazole combined with thrombin is effective and safe for upper gastrointestinal bleeding.