生长抑素、奥美拉唑与凝血酶联合治疗上消化道溃疡性出血的临床观察

Clinical Observation of Combined Application of Somatostatin,Omeprazole and Thrombin in Treatment of Upper Gastrointestinal Ulcer Bleeding

目的 评价生长抑素、奥美拉唑与凝血酶联合治疗上消化道溃疡性出血的临床疗效与安全性,为该方案的临床应用奠定基础.方法 选取我院2011 年3 月-2015 年3 月收治的100 例上消化道溃疡性出血患者,按照随机数字表法分为观察组、对照组,各50 例,均给予奥美拉唑治疗,观察组加用生长抑素、凝血酶治疗.比较两组患者治疗情况,血常规、凝血指标及Blatchford 评分变化,评价两种治疗方案的临床疗效与安全性.结果 观察组止血时间、出血量及住院时间均低于对照组,差异有统计学意义（P 〈 0.05）.两组患者治疗72 h 后Hb、RBC、PLT、Hct、FIB 均较治疗前升高,WBC、PT、APTT、Blatchford 评分均较治疗前降低,观察组Hb、RBC、PLT、Hct 及凝血指标、Blatchford评分改善更为明显,差异有统计学意义（P 〈 0.05）.观察组临床总有效率为82.00%,高于对照组的58.00%,差异有统计学意义（P 〈 0.05）;两组患者不良反应发生率均为8.00%,组间比较差异无统计学意义（P 〉 0.05）.结论 生长抑素、奥美拉唑与凝血酶联合治疗上消化道溃疡性出血有着确切的临床疗效与良好的安全性,对患者临床症状、凝血功能的早期改善具有积极意义.

Objective To evaluate the clinical efficacy and safety of combined application of somatostatin, omeprazoleand thrombin in treatment of upper gastrointestinal ulcer bleeding, and lay a foundation for the application of the treatment.Methods 100 patients with upper gastrointestinal ulcer bleeding from March 2011 to March 2015 in our hospital were selectedand divided into the observation group and the control group （50 cases in each group） by the random number table method. All ofthe patients were treated with omeprazole, while patients in the observation group were treated with the therapy supplementarysomatostatin and thrombin. The changes of the hematology test, coagulation indicators and Blatchford scores between the twogroups were observed and compared, and the clinical efficacy and safety of the two treatments were evaluated. Results Thehemostatic time, hemorrhage volume and hospitalization time in the observation group were lower than those in the control group,the difference was statistically significant （P 〈 0.05）. Compared with the levels before treatment, the Hb, RBC, PLT, Hct, FIBin both of the two groups increased, the WBC, PT, APTT, Blatchford scores decreased after 72 hours treatment, the changes ofthe observation group were more obvious, the difference was statistically significant （P 〈 0.05）. The clinical total effective rateof the observation group was 82.00%, which was higher than that in the control group of 58.00%, the difference was statisticallysignificant （P 〈 0.05）. The incidence of adverse reactions in both of the two groups was 8.00%, showed no statisticaldifference （P 〉 0.05）. Conclusion Combined application of somatostatin, omeprazole and thrombin in the treatment of uppergastrointestinal ulcer bleeding has curative effect and good safety, can positively improve the clinical symptoms and bloodcoagulation function of patients, and it’s worthy of promotion.