蛇毒血凝酶联合兰索拉唑治疗上消化道出血患者凝血功能疗效观察

Effect of Snake Venom Hemagglutinin Combined with Lansoprazole on Coagulation Function in Patients with Upper Gastrointestinal Hemorrhage

目的 观察应用蛇毒血凝酶联合兰索拉唑对上消化道出血患者凝血功能疗效。方法 选取2019年1月—2020年1月期间南部战区总医院收治的112例上消化道出血患者为研究对象,按照就诊顺序随机分为研究组和对照组,各56例。研究组给予蛇毒血凝酶联合兰索拉唑治疗,对照组给予兰索拉唑治疗。治疗3 d后,观察比较两组患者治疗前后凝血功能[纤维蛋白原(Fibrinogen, FIB)、凝血酶原时间(Prothrombin time, PT)、凝血活酶时间(Activated partial thromboplastin time, APTT)、D-二聚体(D dimer, D-D)水平]、临床疗效、止血功效[止血时间、血压稳定时间、腹痛缓解时间、胃管引流量]、再出血率、住院时间及不良反应发生情况。结果 治疗3 d后研究组总有效率为94.64%(53/56)明显优于对照组80.36%(45/56),差异有统计学意义(P<0.05)。治疗3 d后研究组止血功效均优于对照组,差异有统计学意义(P<0.05)。治疗3 d后两组患者PT、APTT、D-D水平均较治疗前降低,FIB水平较治疗前升高,差异有统计学意义(P<0.05);且研究组PT、APTT、D-D水平均较对照组明显降低,FIB水平较对照组明显升高,差异有统计学意义(P<0.05)。治疗后研究组再出血率、住院时间明显低于对照组,差异有统计学意义(P<0.05)。治疗期间,两组患者肝肾功能及血尿常规未见异常;两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论 采用蛇毒血凝酶联合兰索拉唑治疗上消化道出血患者止血效果显著,且可调节凝血功能,安全性高,值得临床推广使用。

Objective To observe the effect of snake venom hemagglutinin combined with lansoprazole on the coagulation function in patients with upper gastrointestinal hemorrhage.Methods This study enrolled 112 patients admitted to the General Hospital of Southern Theater Command due to upper gastrointestinal hemorrhage from January 2019 to January 2020.They were randomly assigned into a treatment group(56 cases, treated with snake venom hemagglutinin combined with lansoprazole)and a control group(56 cases, treated with only lansoprazole).The coagulation functions[fibrinogen(FIB)level, prothrombin time(PT),D-dimer(D-D)level, and activated partial thromboplastin time(APTT)]of the two groups before treatment and 3 days after treatment were compared.Furthermore, the clinical efficacy, hemostatic efficacy[time to hemostasis, blood pressure stabilization time, abdominal pain relief time, and gastric tube drainage],re-hemorrhage rate, length of hospital stay, and incidence of adverse reactions were calculated.Results After 3 days of treatment, the treatment group had higher clinical efficacy(94.64%vs80.36%,P<0.05)and hemostatic efficacy(P<0.05)than the control group.The PT,APTT,and D-D levels in both groups after treatment decreased compared with that before treatment, while the FIB level presented an opposite trend(P<0.05).Additionally, the treatment group had lower PT,APTT,and D-D levels and higher FIB level than the control group(P<0.05).There-hemorrhage rate and length of stay in the treatment group were significantly lower than those in the control group after treatment(P<0.05).The two groups had normal liver and kidney functions, blood and urine routine test results and showed no significant difference in the incidence of adverse reactions(P>0.05).Conclusion Snake venom hemagglutinin combined with lansoprazole can regulate the coagulation functionin the patients with upper gastrointestinal hemorrhage, with significant hemostatic efficacy and high safety, being worthy of popularization in clinical practice.