生长抑素联合奥美拉唑治疗维持性血液透析患者上消化道出血的临床效果

Clinical effect of somatostatin combined with omeprazole in the treatment of upper gastrointestinal hemorrhage in maintenance hemodialysis patients

目的观察生长抑素联合奥美拉唑治疗维持性血液透析患者上消化道出血的临床效果。方法选择2016年2月-2020年1月于湖北省大冶市人民医院肾病内分泌科住院治疗的维持性血液透析并发上消化道出血患者65例,采用随机数字表法分为观察组和对照组,观察组33例采用生长抑素联合奥美拉唑治疗,对照组32例采用奥美拉唑治疗。比较2组患者临床疗效、止血时间、住院时间、输血量,治疗前后血红蛋白水平、红细胞压积,治疗前、治疗第1天、第2天、第3天胃液PH值及不良反应。结果观察组患者总有效率为96.97%,高于对照组的81.25%,差异有统计学意义(x^(2)=4.178,P=0.041);观察组患者止血时间、住院时间均短于对照组,输血量少于对照组,差异均有统计学意义(P<0.01);治疗后,2组患者血红蛋白水平及红细胞压积均较治疗前升高,且观察组高于对照组,差异均有统计学意义(P<0.01);治疗第1天、第2天、第3天,观察组患者胃液pH值均高于对照组,差异有统计学意义(P<0.01);2组不良反应总发生率比较差异无统计学意义(x^(2)=0.196,P=0.658)。结论生长抑素联合奥美拉唑治疗维持性血液透析患者上消化道出血的疗效较好,是目前临床上有效的治疗方案。

Objective To observe the clinical effect of somatostatin combined with omeprazole in the treatment of upper gastrointestinal hemorrhage in maintenance hemodialysis patients.Methods From February 2016 to January 2020,65 patients with maintenance hemodialysis complicated with upper gastrointestinal hemorrhage who were hospitalized in the Department of Nephrology and Endocrinology,Daye People’s Hospital,Hubei Province were selected and divided into treatment group and control group by random number table.33 cases in the observation group were treated with somatostatin combined with omeprazole,and 32 cases in the control group were treated with omeprazole.The clinical efficacy,hemostasis time,hospitalization time,blood transfusion volume,hemoglobin level,hematocrit before and after treatment,pH value of gastric juice before treatment and on the first day,the second day,the third day of treatment,and adverse reactions were compared between the two groups of patients.Results The total effective rate of the patients in the observation group was 96.97%,which was higher than the control group’s 81.25%,the difference was statistically significant(x^(2)=4.178,P=0.041).The hemostasis time and hospital stay in the observation group were shorter than those in the control group,and the blood transfusion volume was less than that in the control group,the differences were statistically significant(P<0.01).After treatment,the levels of hemoglobin and hematocrit of the two groups were higher than before treatment,and the observation group was higher than the control group,the difference were statistically significant(P<0.01).On the 1,2,and 3 days of treatment,the gastric juice pH value of the observation group were higher than that of the control group,and the difference were statistically significant(P<0.01).There was no significant difference in the total incidence of adverse reactions between the two groups(x^(2)=0.196,P=0.658).Conclusion Somatostatin combined with omeprazole is effective in treating upper gastrointestinal bleeding in maintenance hemodialysis patients,and is currently a clinically effective treatment plan.