奥美拉唑联合奥曲肽治疗老年性消化性溃疡并上消化道出血的临床观察

Clinical study of Omeprazole combined with Somatostatin for elderly patients with peptic ulcer induced upper gastrointestinal bleeding

目的探讨奥美拉唑联合奥曲肽治疗老年消化性溃疡并上消化道出血的临床疗效。方法将70例老年消化性溃疡并上消化道出血患者按随机数字表分法分为治疗组和对照组,每组各35例患者。对照组采用奥美拉唑治疗,治疗组采用奥美拉唑联合奥曲肽治疗,连续治疗14 d后评价临床疗效,观察治疗前后临床症状、胃镜下溃疡愈合情况,观察治疗后12、24、48、72 h时止血情况,记录患者潜血转阴时间、住院时间及不良反应情况,随访1年并观察出血复发情况。结果治疗组临床疗效有效率为94.3%,对照组为82.9%,治疗组临床疗效有效率显著高于对照组(χ2=6.808,P<0.01);治疗组12、24、48、72 h止血率分别为74.3%、82.9%、85.7%、94.3%,显著高于对照组(χ2值分别为4.730、4.152、5.581、6.808,P<0.05);治疗组潜血转阴时间和出院时间分别为(4.58±1.53)d和(7.26±2.30)d,均显著低于对照组(t值分别为4.392、3.830,P<0.05);治疗组随访期内出血复发率为11.8%,对照组为54.5%,两组出血复发率比较差异有统计学意义(χ2=4.693,P<0.05)。两组均无严重不良反应。结论奥美拉唑联合奥曲肽治疗老年消化性溃疡并上消化道出血临床疗好,安全可靠,值得临床推广应用。

Objective To evaluate the efficacy and safety of Omeprazole combined with Somatostatin for the treatment of elderly patients with peptic ulcer induced upper gastrointestinal bleeding. Methods Totally 70 cases of elderly patients with peptic ulcer induced UGB were randomly divided into the treatment group（ n = 35 ） and the control group（ n = 35 ）. Patients in the control group received continuous omeprazole, while those in the treatment group received somatostatin combined with omeprazole. The clinical efficacy was evaluated after continuous treatment of 14 dyas. The pre-treatment and post-treatment clinical symptoms, ulcer healing by gastroscopy, hemostatic rate in 12,24,48 hours after treatment were observed, and the clearance time of occult blood, hospitalization time, adverse reactions and recurrent bleeding during the study period were also observed. Results The efficient of clinical efficacy of the treatment group was 94.3 % , while that of the control group was 82.9 % （ x^2 = 6. 808, P 〈 0.01 ）. The hemostatic rate of treatment group was respectively 74.3% ,82.9% ,85.7% and 94.3% in 12,24,48 and 72 hours after treatment,and they were significantly higher than those of the control group（ x^2 value were 4. 730,4. 152,5. 581 and 6. 808 respectively ,P 〈 0.05 ）. The clearance time of occult blood and hospitalization time of treatment group was respectively （4.58 ± 1.53 ） days and （7.26 ± 2.30 ） days, and they were significantly lower than those of the control group （t value were 4. 392, 3. 830 respectively, P 〈 0.05 ）. The recurrent bleeding rate during the study period of treatment group was 11.8% ,while that of the control group was 54.5% （x^2 =4. 693 ,P 〈 0.05 ）. There were no serious adverse reactions observed. Conclusion The Omeprazole combined with Somatostatin has good clinical efficacy, it is safe, reliable and worthy of clinical application for treating the elderly patients with peptic ulcer induced UGB.