奥曲肽联合奥美拉唑治疗急性上消化道出血的临床效果研究

Study on clinical effect of octreotide combined with omeprazole in the treatment of acute upper gastrointestinal hemorrhage

目的研究奥曲肽联合奥美拉唑治疗急性上消化道出血(AUGH)的临床疗效,为临床医师选择合理用药方案提供参考。方法68例AUGH患者作为研究对象,依据随机数字表法分为A组和B组,每组34例。A组患者给予奥美拉唑治疗,B组患者给予奥美拉唑联合奥曲肽治疗。比较两组凝血功能指标[凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、D-二聚体(D-D)],临床相关指标(输血量、呕血消失时间、止血时间、住院时间),不良反应发生情况。结果B组患者的PT(12.05±0.82)s、APTT(26.05±1.92)s短于A组的(13.38±0.86)、(35.24±1.86)s,FIB(3.39±0.26)g/L高于A组的(3.02±0.24)g/L,D-D(0.63±0.08)μg/L低于A组的(1.35±0.17)μg/L,差异具有统计学意义(P<0.05)。B组患者的输血量(121.35±24.26)ml少于A组的(151.28±31.17)ml,呕血消失时间(2.14±0.22)d、止血时间(2.15±0.47)d及住院时间(5.16±1.34)d均短于A组的(3.85±0.17)、(3.72±0.68)、(8.29±1.15)d,差异具有统计学意义(P<0.05)。两组患者的不良反应发生率比较差异无统计学意义(P>0.05)。两组不良反应患者经停药或对症处理后,不良反应均消失。结论AUGH患者行奥美拉唑联合奥曲肽治疗可改善凝血功能、保证用药安全,值得推崇。

Objective To study the clinical efficacy of octreotide combined with omeprazole in the treatment of acute upper gastrointestinal hemorrhage(AUGH),so as to provide reference for clinicians to choose rational drug use.Methods A total of 68 AUGH patients were divided into group A and group B according to random numerical table,with 34 patients in each group.Patients in group A were treated with omeprazole,and patients in group B were treated with omeprazole and octreotide.Both groups were compared in terms of coagulation function indexes[prothrombin time(PT),activated partial thrombin time(APTT),fibrinogen(FIB),D-dimer(D-D)],clinical related indexes(blood transfusion volume,hematemesis time,hemostasis time,hospital stay)and the occurrence of adverse reactions.Results PT of(12.05±0.82)s and APTT of(26.05±1.92)s in group B were shorter than those of(13.38±0.86)and(35.24±1.86)s in group A;FIB of(3.39±0.26)g/L in group B was higher than that of(3.02±0.24)g/L in group A;D-D of(0.63±0.08)μg/L in group B was lower than that of(1.35±0.17)μg/L in group A;the differences were statistically significant(P<0.05).The blood transfusion volume was(121.35±24.26)ml in group B,which was less than that of(151.28±31.17)ml in group A;group B had hematemesis time of(2.14±0.22)d,hemostasis time of(2.15±0.47)d and hospital stay of(5.16±1.34)d,which were shorter than those of(3.85±0.17),(3.72±0.68)and(8.29±1.15)d in group A;the differences were statistically significant(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).The adverse reactions disappeared in both groups after drug withdrawal or symptomatic treatment.Conclusion Omeprazole in combination with octreotide for AUGH patients can improve the coagulation function and ensure the safety of medication,which is worthy of praise.