凝血酶联合奥曲肽对急性消化道出血患者炎性因子水平的影响及安全性分析

Effect of thrombin combined with octreotide on level of inflammatoryfactors in patients with acute gastrointestinalbleeding and its safety analysis

目的研究凝血酶联合奥曲肽对急性消化道出血患者炎性因子水平的影响及安全性。方法选取2019年3月至2020年10月佛山市第五人民医院消化内科收治的99例急性消化道出血患者,采用随机数字表法分为对照组49例和治疗组50例。对照组使用注射用醋酸奥曲肽治疗,治疗组在对照组基础上使用凝血酶冻干粉治疗,两组均治疗3~5 d。比较两组治疗后临床疗效与止血时间、治疗期间输血量与不良反应发生情况,以及治疗前后血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平。结果①治疗组治疗后临床总有效率高于对照组(P<0.05)。②治疗组治疗后止血时间短于对照组,且治疗期间输血量低于对照组(P<0.05)。③两组治疗后血清IL-6、TNF-α水平较治疗前下降,且治疗组低于对照组(P<0.05)。④治疗组治疗后不良反应总发生率低于对照组(P<0.05)。结论凝血酶联合奥曲肽治疗急性消化道出血患者疗效更佳,能够有效减轻患者应激反应程度,降低炎性因子水平,且安全性更高。

[Objective]To study the effect of thrombin combined with octreotide on the level of inflammatory factors in patients with acute gastrointestinal bleeding and its safety.[Methods]Ninety-nine patients with acute gastrointestinal bleeding admitted to the department of gastroenterology of our hospital from March 2019 to October 2020 were selected as the subjects,and they were divided into the control group and the treatment group.Forty-nine cases in the control group were injected with octreotide acetate,and 50 cases in treatment group were given with thrombin freeze-dried powder on the basis of the control group,both groups of patients were treated for 3~5 d.The clinical efficacy and hemostasis time after treatment,adverse reactions and blood transfusion during treatment,serum IL-6 and TNF-αlevels before and after treatment between the two groups were compared.[Results]After treatment,the total clinical effective rate of patients in the treatment group was higher than that in the control group,the incidence of total adverse reactions was lower than that of the control group,and the bleeding time was shorter than that of the control group.The amount of blood transfusion in the treatment group during treatment was lower than that in the control group;compared with before treatment,serum IL-6 and TNF-αlevels of the two groups of patients decreased significantly after treatment,and the treatment group was lower than the control group(all P<0.05).[Conclusion]Thrombin combined with octreotide had better efficacy in the treatment of patients with acute gastrointestinal bleeding,could effectively reduce the patient's stress response,and reduce the level of inflammatory factors with higher security.