奥美拉唑联合血凝酶治疗急性上消化道出血患者的临床研究

Clinical Study on the Treatment of Patients with Acute Upper Gastrointestinal Bleeding by Omeprazole Combined with Hemocoagulase

目的研究奥美拉唑联合血凝酶治疗急性上消化道出血(acute upper gastrointestinal bleeding,AUGIB)患者的效果。方法方便选取2020年1—12月厦门市中医院急诊科收治的236例AUGIB患者为研究对象,采用随机数表法分为两组,各118例。对照组采用奥美拉唑治疗,观察组采用奥美拉唑联合血凝酶治疗。分析两组患者临床疗效、治疗前后血常规指标、凝血功能、血清氧化应激指标及不良反应。结果与对照组疗效比较,观察组更高,差异有统计学意义(χ^(2)=9.674,P<0.05)。治疗后,两组血凝酶原时间(PT)、活化部分凝血活酶时间(APTT)较治疗前缩短,且观察组短于对照组,两组D-二聚体(D-D)、WBC、血清晚期蛋白质氧化产物(AOPP)、8-羟基脱氧鸟嘌呤核苷(8-OHdG)、氧化型低密度脂蛋白(ox-LDL)水平均较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后,两组纤维蛋白原(FIB)、RBC、PLT、HB、血清维生素E(Vit E)水平较治疗前升高,观察组高于对照组,差异有统计学意义(P<0.05)。观察组和对照组不良反应总发生率分别为9.32%、6.78%,差异无统计学意义(P>0.05)。结论奥美拉唑联合血凝酶治疗AUGIB效果显著,能增加RBC、HB含量,调节凝血功能,有效减轻氧化应激。

Objective To study the effect of omeprazole combined with hemocoagulase in the treatment of patients with acute upper gastrointestinal bleeding(AUGIB).Methods A total of 236 AUGIB patients admitted to the Emergency Department of Xiamen Hospital of Traditional Chinese Medicine from January to December 2020 were conveniently selected as the research objects,and were divided into two groups with 118 cases in each group by random number table method.The control group was treated with omeprazole,and the observation group was treated with omeprazole combined with hemagglutinin.The clinical efficacy,blood routine indexes,coagulation function,serum oxidative stress indexes and adverse reactions of the two groups were analyzed.Results Curative effect compared with control group,the observation group was higher,the difference was statistically significant(χ^(2)=9.674,P<0.05).After treatment,the prothrombin time(PT)and activated partial thrombin time(APTT)of the two groups were shorter than before treatment,and the observation group was shorter than the control group.The levels of Ddimer(DD),WBC,serum late protein oxidation product(AOPP),8hydroxydeoxyguanine nucleoside(8OHdG)and oxidized low density lipoprotein(oxLDL)in two groups were lower than before treatment,and the observation group was lower than control group,the difference was statistically significant(P<0.05).After treatment,the levels of fibrinogen(FIB),RBC,PLT,HB and serum vitamin E(Vit E)in two groups were higher than before treatment,and the observation group was higher than control group,the difference was statistically significant(P<0.05).The total incidence of adverse reactions in observation group and control group was 9.32%and 6.78%,respectively,the difference was not statistically significant(P>0.05).Conclusion Omeprazole combined with hemagglutinin in the treatment of AUGIB has significant effect,which can increase RBC and HB content,regulate coagulation function and effectively reduce oxidative stress.