生长抑素联合泮托拉唑治疗急性非静脉曲张性上消化道出血患者的疗效及对其凝血功能的影响

Efficacy of Somatostatin combined with Pantoprazole in the treatment of patients with acute non-variceal upper gastrointestinal bleeding and its effect on coagulation function

目的探讨生长抑素联合泮托拉唑治疗急性非静脉曲张性上消化道出血(ANVUGIB)患者的疗效及对其凝血功能、血液流变学指标的影响,以便临床寻找更有效的治疗方案。方法按随机数字表法将江阴市青阳医院2020年9月至2021年9月收治的102例ANVUGIB患者分为两组,各50例。予以两组患者抗感染、补充血容量、维持酸碱平衡等常规对症治疗,同时予以对照组患者泮托拉唑治疗,在此基础上观察组患者采用生长抑素治疗,两组患者均连续治疗3 d。比较两组患者临床疗效、止血时间、血红蛋白(Hb)降低程度、住院时间,治疗前后凝血功能、血液流变学指标,以及治疗期间不良反应发生情况。结果观察组患者临床总有效率显著高于对照组;观察组患者止血时间、住院时间均显著短于对照组;观察组患者Hb降低程度显著小于对照组;与治疗前比,治疗后两组患者血浆活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)均显著缩短,且观察组显著短于对照组;两组患者血浆D-二聚体(D-D)水平均显著降低,且观察组显著低于对照组;两组患者血浆纤维蛋白原(FIB)、全血高切黏度(HSV)、全血低切黏度(LSV)、血浆黏度(PSV)水平均显著升高,且观察组显著高于对照组(均P<0.05);两组患者不良反应总发生率比较,差异无统计学意义(P>0.05)。结论应用生长抑素联合泮托拉唑治疗ANVUGIB可有效缓解患者的临床症状,提高临床疗效,改善患者的凝血功能和血液流变学,且安全性高。

Objective To investigate the efficacy of Somatostatin combined with Pantoprazole in the treatment of patients with acute non-variceal upper gastrointestinal bleeding(ANVUGIB)and its effects on coagulation function and hemorheology indexes,in order to find more effective treatment options in the clinic.Methods According to the random number table method,102 ANVUGIB patients admitted to Qingyang Hospital of Jiangyin from September 2020 to September 2021 were divided into two groups,with 50 cases in each group.The two groups of patients were given routine symptomatic treatment such as anti-infection,supplementing blood volume,maintaining acid-base balance,etc.At the same time,patients in the control group were treated with Pantoprazole,on this basis,the patients in the observation group were treated with Somatostatin,both groups were treated for 3 consecutive days.The clinical efficacy,hemostasis time,hemoglobin(Hb)reduction degree,hospitalization time,coagulation function and hemorheology indexes before and after treatment,and adverse reactions during treatment were compared between the two groups.Results The total clinical effective rates of the observation group was significantly higher than the control group;the hemostatic time and hospitalization time of the observation group were significantly shorter than those of the control group;the Hb reduction degree in the observation group was significantly lower than that in the control group;compared with before treatment,the plasma activated partial thromboplastin time(APTT)and prothrombin time(PT)of the two groups of patients after treatment significantly shortened,and the observation group was significantly shorter than the control group;plasma D-dimer(D-D)levels in both groups significantly decreased,and the observation group was significantly lower than the control group;the levels of plasma fibrinogen(FIB),whole blood high shear viscosity(HSV),low shear viscosity(LSV)and plasma viscosity(PSV)in the two groups significantly increased,and the observation group was significantly higher than the control group(all P<0.05);there was no significant difference in the total incidence of adverse reactions between the two groups of patients(P>0.05).Conclusion The application of Somatostatin combined with Pantoprazole in the treatment of ANVUGIB can effectively relieve the clinical symptoms of patients,improve the clinical efficacy,improve the coagulation function and hemorheology of patients,and has high safety.