艾司奥美拉唑联合生长抑素治疗上消化道出血的临床应用

The Clinical Application of Esomeprazole with Somatostatin in the Treatment of Upper Gastrointestinal Hemorrhage

目的:研究艾司奥美拉唑联合生长抑素在治疗上消化道出血的疗效、不良反应,并进行成本-效果分析,为临床合理用药提供参考。方法:选取2016年7月—2017年12月在上饶市人民医院就诊的657例上消化道出血患者为研究对象,将患者分为3组,其中实验组208例,对照组1232例,对照组2217例。实验组给予艾司奥美拉唑联合生长抑素静脉滴注,对照组1给予奥美拉唑钠联合生长抑素静脉滴注,对照组2给予兰索拉唑联合生长抑素静脉滴注。观察三组患者止血时间、住院天数、质子泵抑制剂及生长抑素费用、治疗总费用、不良反应,比较不同方案治疗上消化道出血的安全性和有效性,并运用经济学方法进行成本-效果分析。结果:实验组患者止血时间和住院天数均显著短于对照组(P<0.05)。实验组患者临床总有效率显著高于对照组(P<0.05),不良反应发生率较对照组低。成本-效果比(Cost/Effectiveness,C/E)分别为177.63、203.33、235.43。结论:艾司奥美拉唑钠联合生长抑素能够在保证用药安全性的前提下,缩短出血时间,提高临床疗效,其安全性、有效性、经济性值得肯定。

Objective: The curative effect,adverse drug reaction (ADR)and cost-effectiveness(C/E)of esomeprazole with somatostatin in the treatment of upper gastrointestinal hemorrhage were observed, so as to provide information for rational clinical use of drug. Methods: 657 patients withupper gastrointestinal hemorrhage in Shangrao People's Hospital from July 2016 to December 2017 were selected for the study, and divided into 3 groups, 208 cases in intoexperimental group, 232 cases in control group 1, 217 cases in control group 2. The patients in intoexperimental group were treated with esomeprazole with somatostatin intravenous drip. Control group 1 patients were treated with omeprazole with somatostatin intravenous drip, and control group 2 patients were treated with lansoprazole with somatostatin intravenous drip, the changes of hemostasis time, hospitalization days, cost of proton-pump inhibitors(PPIs),cost of somatostatin, total cost of treatment and adverse reactions between the 3 groups were observed and the safety and efficacy were compared. The data were evaluated with cost-effectiveness analysis. Results: The bleeding time and hospitalization days of intoexperimental group were significantly shorter than those of control groups (P<0.05). The total effective rate of intoexperimental group was significantly higher than that of control groups(P<0.05), the rate of adverse reactions of intoexperimental group is lower than that of control groups. The cost-effectiveness ratios were 177.63, 203.33, 235.43. Conclusion: Esomeprazole with somatostatin can guarantee the safety of medication, shorten the bleeding time, and improve the clinical efficacy. It's safety,effectiveness and economy are worthy of recognition.