奥曲肽联合奥美拉唑治疗消化性溃疡急性上消化道出血的临床效果及对凝血功能的影响

Clinical effect of octreotide combined with omeprazole in treatment of acute upper gastrointestinal bleeding from peptic ulcer and its influence coagulation function

目的探讨消化性溃疡急性上消化道出血(acute upper gastrointestinal hemorrhage,AUGH)患者给予奥曲肽联合奥美拉唑治疗的临床效果及对凝血酶原时间(prothrombin time,PT)、活化部分凝血活酶时间(activated partial thromboplastin time,APTT)和凝血酶时间(thrombin time,TT)的影响。方法选择2021年10月至2022年10月郑州大学第一附属医院感染性疾病科收治的98例消化性溃疡AUGH患者为研究对象,按治疗用药不同,将常规干预基础上采用奥美拉唑治疗的49例作为对照组,将对照组基础上联合奥曲肽治疗的49例作为观察组,比较两组患者的凝血功能以及临床治疗有效率等。结果两组患者治疗前的凝血功能各项指标差异均无统计学意义(P>0.05);治疗后观察组TT、APTT和PT水平分别为(15.65±2.33)s、(36.57±4.61)s和(11.35±0.57)s,明显优于对照组(P<0.05);观察组有效率(97.96%)高于对照组(79.59%)(P<0.05);观察组在大便隐血转阴、住院时间以及止血时间等方面分别为(6.59±0.44)d、(6.57±3.11)d及(41.67±5.49)h,均短于对照组(P<0.05);观察组不良反应发生率8.16%,对照组发生率为10.21%,差异无统计学意义(P>0.05)。结论奥美拉唑联合奥曲肽对消化性溃疡AUGH疗效显著,能够对患者各项凝血功能指标进行改善,安全性高,值得临床推广。

Objective To investigate the clinical effect of octreotide combined with omeprazole in acute upper gastroin-testinal hemorrhage(AUGH)patients with peptic ulcer and its effect on prothrombin time(PT),activated partial thromboplastin time(APTT)and thrombin time(TT).Methods Totally 98 patients with AUGH admitted to our hos-pital from October 2021 to October 2022 were retrospectively selected to be included in the study.According to different treatment methods,The group reference was treated with omeprazole alone,while the study group was treated with ome-prazole combined with octreotide to compare the coagulation function and clinical treatment effectiveness of the two groups.Results There was no significant diference in the indexes of coagulation function between the two groups before treatment(P>0.05).Afer treatment,TT,APTT and PT levels in the observation group were(15.65±2.33)s,(36.57±4.61)s and(11.35±0.57)s,respectively,which were significantly better than those in the control group(P<0.05).The effective rate of observation group(97.96%)was higher than that of control group(79.59%)(P<0.05).The conversion of fecal occult blood to negative,hospitalization time and hemostasis time in the observation group were(6.59±0.44)d,(6.57±3.11)d and(41.67±5.49)h,respectively,which were shorter than those in the control group(P<0.05).The incidence of adverse reactions was 8.16%in the observation group and 10.21%in the control group,with no statistical significance(P>0.05).Conclusion Omeprazole combined with octreotide has a significant effect on the treatment of acute upper gastrointestinal bleeding.In addition to improving various clotting function indexes in patients,it can also promote the further improvement of patients'daily life quality,which has high clinical application value and is worthy of popularization and application.