生长抑素联合质子泵抑制剂治疗消化道出血的可行性及安全性分析

Feasibility and Safety Analysis of Somatostatin Combined with Proton Pump Inhibitors in the Treatment of Gastrointestinal Bleeding

目的探讨生长抑素联合质子泵抑制剂治疗消化道出血的可行性及安全性。方法选取2019年1月—2022年11月徐州市贾汪区人民医院收治的92例消化道出血患者为研究对象,以随机数表法将患者分成两组,所有研究对象均接受常规治疗,在此基础上对照组(46例)加用艾司奥美拉唑治疗,观察组(46例)在对照组基础上加用生长抑素治疗。比较两组输血量、止血时间、住院时间、再出血率,治疗前后血浆凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(D-D)、Rockall评分、生活质量评分,治疗期间不良反应发生情况。结果观察组止血时间(14.13±1.24)h、住院时间(7.89±1.17)d短于对照组的止血时间(25.15±1.26)h、住院时间(12.52±1.25)d,观察组输血量(146.25±6.32)mL少于对照组的输血量(216.26±7.35)mL,差异有统计学意义(t=42.279、18.341、48.984,P<0.05)。观察组再出血率2.17%低于对照组21.74%,差异有统计学意义(χ^(2)=8.364,P=0.004)。与治疗前相比,治疗后两组PT、APTT均缩短,D-D、Rockall评分均降低,且观察组PT、APTT短于对照组,D-D、Rockall评分低于对照组,差异有统计学意义(P<0.05)。与治疗前相比,治疗后两组生活质量评分均升高,且观察组生活质量评分高于对照组,差异有统计学意义(P<0.05)。结论生长抑素联合质子泵抑制剂治疗消化道出血疗效确切,改善凝血功能,缩短住院时间,提升生活质量,且不会增加不良反应,安全性较高。

Objective To investigate the feasibility and safety of somatostatin combined with proton pump inhibitors in the treatment of gastrointestinal bleeding.Methods 92 patients with gastrointestinal bleeding admitted to People′s Hospital of Jiawang District in Xuzhou City from January 2019 to November 2022 were selected as the research subjects,and the patients were divided into two groups using a random number table method.All subjects received conventional treatment.On this basis,the control group(46 cases)was treated with Omeprazole,and the observation group(46 cases)was treated with somatostatin on the basis of the control group.The blood transfusion volume,hemostasis time,hospitalization time,rebleeding rate,prothrombin time(PT),activated partial thromboplastin time(APTT),D-dimer(D-D),Rockall score,quality of life score before and after treatment,and adverse reactions during treatment were compared between the two groups.Results The hemostasis time(14.13±1.24)h and hospitalization time(7.89±1.17)d in the observation group were shorter than those in the control group(25.15±1.26)h and(12.52±1.25)d,the blood transfusion volume(146.25±6.32)mL in the observation group was lower than that in the control group(216.26±7.35)mL,and the difference was statistically significant(t=42.279,18.341,48.984,P<0.05).The rebleeding rate in the observation group was 2.17%lower than that in the control group,which was 21.74%,and the difference was statistically significant(χ^(2 )=8.364,P=0.004).Compared with before treatment,after treatment,the PT and APTT of both groups were shortened,and the D-D and Rockall scores were reduced,moreover,the PT and APTT of the observation group were shorter than those of the control group,and the D-D and Rockall scores were lower than those of the control group,and the difference was statistically significant(P<0.05).Compared with before treatment,the quality of life scores of both groups increased after treatment,and the quality of life scores of the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).Conclusion Somatostatin combined with proton pump inhibitors is effective in the treatment of gastrointestinal bleeding,improves blood coagulation function,shortens hospital stay,improves quality of life,and does not increase adverse reactions,with high safety.