内镜下金属夹止血联合大剂量奥美拉唑对上消化道出血患者血管活性因子及生长因子水平的影响

Effects of endoscopic metal clip hemostasis combined with high-dose omeprazole on levels of vasoactive factors and growth factors in patients with upper gastrointestinal bleeding

目的探讨内镜下金属夹止血联合大剂量奥美拉唑治疗上消化道出血的效果。方法选择2019年10月至2021年5月收治的72例上消化道出血患者为研究对象,按照随机数字表法将其分为对照组与观察组,各36例。对照组采用内镜下金属夹止血联合常规剂量奥美拉唑,观察组采用内镜下金属夹止血联合大剂量奥美拉唑。比较两组的治疗效果。结果观察组的止血时间、大便隐血转阴时间、住院时间短于对照组,治疗24 h胃液pH高于对照组(P<0.05)。治疗后,观察组的一氧化氮(NO)水平低于对照组,内皮素-1(ET-1)、血栓素B2(TXB2)水平高于对照组(P<0.05)。治疗后,观察组的表皮生长因子(EGF)、转化生长因子-α(TGF-α)水平高于对照组(P<0.05)。治疗后,观察组的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)短于对照组,纤维蛋白原(FIB)水平、血小板计数(PLT)高于对照组(P<0.05)。治疗后,观察组的胃泌素(GAS)、胃动素(MTL)水平低于对照组,生长抑素(SS)水平高于对照组(P<0.05)。结论内镜下金属夹止血联合大剂量奥美拉唑用于上消化道出血中能提高止血效果,调节血管活性因子表达,促进胃黏膜修复,调节胃肠激素水平,值得临床推广和应用。

Objective To investigate the effect of endoscopic metal clip hemostasis combined with high-dose omeprazole in the treatment of upper gastrointestinal bleeding.Methods A total of 72 patients with upper gastrointestinal bleeding admitted from October 2019 to May 2021 were selected as the study objects,and the patients were divided into control group and observation group according to random number table method,with 36 cases in each group.The control group was treated with endoscopic metal clip hemostasis combined with conventional dose omeprazole,while the observation group was treated with endoscopic metal clip hemostasis combined with high-dose omeprazole.The therapeutic effects of the two groups were compared.Results The hemostasis time,fecal occult blood negative conversion time and hospital stay of the observation group were shorter than those of the control group,and the 24 h gastric juice pH was higher than that of the control group(P<0.05).After treatment,the level of nitric oxide(NO)in the observation group was lower than that in the control group,and the levels of endothelin-1(ET-1)and thromboxane B2(TXB2)were higher than those in the control group(P<0.05).After treatment,the levels of epidermal growth factor(EGF)and transforming growth factor-α(TGF-α)in the observation group were higher than those in the control group(P<0.05).After treatment,the prothrombin time(PT)and activated partial thromboplastin time(APTT)in the observation group were shorter than those in the control group,and the fibrinogen(FIB)level and platelet count(PLT)were higher than those in the control group(P<0.05).After treatment,the levels of gastrin(GAS)and motilin(MTL)in the observation group were lower than those in the control group,and the level of somatostatin(SS)was higher than that in the control grooup(P<0.05).Conclusion Endoscopic metal clip hemostasis combined with high-dose omeprazole applied in upper gastrointestinal bleeding can improve the hemostatic effect,regulate the expression of vasoactive factors,promote the repair of gastric mucosa,and regulate the levels of gastrointestinal hormones,which is worthy of clinical promotion and application.