奥美拉唑联合血凝酶治疗胃溃疡伴上消化道出血

Therapeutic effect of omeprazole combined with hemocoagulase on gastric ulcer with the upper gastrointestinal bleeding

目的分析奥美拉唑联合血凝酶对胃溃疡伴上消化道出血的临床疗效。方法将92例胃溃疡伴上消化道出血患者随机分为观察组与对照组,各46例。2组入院后均接受常规治疗,对照组在常规治疗的基础上予40 mg的奥美拉唑钠静脉滴注治疗,12小时1次;观察组在对照组的基础上予1单位的血凝酶静脉注射治疗,12小时1次。2组均治疗3 d。记录2组的止血时间和再出血情况;检测2组治疗前后血清表皮生长因子(EGF)、血管内皮生长因子(VEGF)、肿瘤坏死因子-α(TNF-α)和超氧化物歧化酶(SOD)水平;统计2组总有效率和不良反应发生率。结果观察组止血时间显著短于对照组(P<0.01),再出血率均显著低于对照组(P<0.05);治疗后2组血清EGF、VEGF、SOD水平较治疗前显著升高(P<0.05),观察组显著高于对照组(P<0.05);治疗后2组血清TNF-α水平较治疗前显著降低(P<0.05),且对照组高于观察组(P<0.05);观察组总有效率(91.31%,42/46)高于对照组(76.09%,35/46)(P<0.05);2组不良反应总发生率无显著差异(P>0.05)。结论奥美拉唑联合血凝酶治疗胃溃疡伴上消化道出血可缩短出血时间,降低再出血率和血清炎性因子水平,促进胃溃疡和上消化道损伤的愈合,且安全性高,治疗效果优于单独应用奥美拉唑。

Objective To analyze the therapeutic effect of omeprazole combined with hemocoagulase on gastric ulcer with the upper gastrointestinal bleeding.Methods A total of ninety-two gastric ulcer patients with the upper gastrointestinal bleeding were randomly divided into an observation group and a control group,with 46 cases in each group.Both groups received the conventional treatment after admission,and the control group was additionally treated with the 40 mg omeprazole sodium intravenous infusion,1 time/12 h,while the observation group was additively given 1 unit of hemocoagulase intravenously,1 time/12 h,both for three consecutive days.The hemostasis time and rehaemorrhagia in the two groups were recorded,the levels of serum epidermal growth factor(EGF),vascular endothelial growth factor(VEGF),tumor necrosis factor-α(TNF-α)and superoxide dismutase(SOD)in both groups were detected before and after treatment,and the total effective rate and the incidence of adverse reactions in the two groups were calculated.Results The hemostasis time in the observation group was significantly shorter than that in the control group(P<0.01),and the rehaemorrhagia rate was significantly lower than that in the control group(P<0.05).After treatment,the serum levels of EGF,VEGF and SOD in the two groups were significantly increased compared with before treatment(P<0.05),and the observation group was significantly higher than the control group(P<0.05).After treatment,the serum TNF-α levels in both groups were significantly decreased compared with before treatment(P<0.05),and the control group was higher than the observation group(P<0.05).The total effective rate in the observation group(91.31%,42/46)was higher than that in the control group(76.09%,35/46)(P<0.05),while there was no significant difference in the overall incidence of adverse reactions between the two groups(P>0.05).Conclusion Omeprazole combined with hemocoagulase in the treatment of gastric ulcer with the upper gastrointestinal bleeding can shorten the bleeding time,reduce the rehaemorrhagia rate and the serum inflammatory factors levels,and promote the healing of gastric ulcer and upper digestive track injuries,and it has a higher safety,and its therapeutic effect is superior to omeprazole alone.