生长抑素、奥曲肽治疗非静脉曲张性上消化道出血的疗效对比

The effects of somatostatin and octreotide on non-variceal upper gastrointestinal bleeding

目的对比分析生长抑素及其类似物奥曲肽联合泮托拉唑治疗非静脉曲张性上消化道出血的有效性、安全性。方法对2017年1月~2019年1月于我院消化内科接受泮托拉唑联合生长抑素或奥曲肽治疗非静脉曲张性上消化道出血患者进行回顾性分析。比较2种治疗方案止血时间、住院天数及不良反应发生情况的差异。结果符合纳入标准的患者共72例,其中生长抑素联合泮托拉唑治疗37例,奥曲肽联合泮托拉唑治疗35例。奥曲肽组的止血时间(28.28±19.10)h和住院天数(5.86±1.48)d,低于生长抑素组的止血时间(38.29±16.43)h和住院天数(7.05±1.91)d,差异具有统计学意义(P<0.05,P<0.05)。生长抑素组患者中显效3例,有效32例,无效2例;奥曲肽组患者显效16例,有效17例,无效2例,两组止血疗效差异具有统计学意义(P<0.05)。两组不良反应发生率(生长抑素组5.41%,奥曲肽组2.86%)无明显差异(P>0.05)。结论奥曲肽较生长抑素能进一步缩短患者的止血时间、减少其住院天数,且具有较好的安全性,可在非静脉曲张性上消化道出血的临床治疗中优先选用。

Objective To compare the efficacy and safety of somatostatin and its analogue octreotide combined with pantoprazole in the treatment of non-variceal upper gastrointestinal bleeding.Methods A retrospective analysis was conducted on inpatients suffering with non-variceal upper gastrointestinal bleeding from Jan 2017 to Jan 2019,who were treated with somatostatin or octreotide combined with pantoprazole.The differences of hemostatic time,hospital stay,and adverse reactions between the two groups were compared.Results 72 patients were enrolled,including 37 patients treated with somatostatin combined with pantoprazole and 35 patients treated with octreotide combined with pantoprazole.The hemostatic time(28.28±19.10)h and hospitalization days(5.86±1.48)d of the octreotide group were significantly shorter compared with the hemostatic time(38.29±16.43)h and hospitalization days(7.05±1.91)d in the somatostatin group(P<0.05,P<0.05).The hemostatic efficiency within 72 hours of octreotide was better than somatostatin(P<0.05).There was no significant difference in the incidence of adverse reaction(5.41% in the somatostatin group and 2.86% in the octreotide group)between the two groups(P>0.05).Conclusion Compared with somatostatin,octreotide may further shorten the hemostatic time and hospital stay of patients with few adverse reactions,which may be the priority selection for the treatment non-varicose upper gastrointestinal bleeding.