四联疗法配合消化内镜治疗消化性溃疡出血的效果及对凝血指标的影响

Effect of Quadruple Therapy Combined with Digestive Endoscopy on Peptic Ulcer Bleeding and Its Influence on Coagulation Index

目的:探讨四联疗法配合消化内镜治疗消化性溃疡出血(PUB)的效果及对凝血指标的影响。方法:选取2022年6月—2023年5月岑溪市人民医院收治的76例PUB患者,根据不同治疗方案分为联合组与常规组,各38例。常规组予以四联疗法治疗,联合组在四联疗法基础上予以消化内镜治疗,比较两组治疗效果。结果:联合组出血量少于常规组,止血时间、溃疡愈合时间早于常规组,差异有统计学意义(P<0.05)。治疗后,两组凝血酶时间(TT)、凝血酶原时间(PT)、D-二聚体(D-D)、国际标准化比值(INR)均低于治疗前,且联合组均低于常规组,差异有统计学意义(P<0.05)。治疗前,两组胃泌素-17水平比较,差异无统计学意义(P>0.05);治疗后,两组胃泌素-17水平均高于治疗前,且联合组明显高于常规组,差异有统计学意义(P<0.05)。联合组不良反应总发生率低于常规组,差异有统计学意义(P<0.05)。结论:四联疗法联合消化内镜治疗PUB的效果确切,可有效改善机体凝血功能,快速止血以减少出血量,不良反应发生率低,安全性较高。

Objective:To investigate the effect of quadruple therapy combined with digestive endoscopy in the treatment of peptic ulcer bleeding(PUB)and its influence on coagulation index.Method:A total of 76 PUB patients admitted to Cenxi People's Hospital from June 2022 to May 2023 were selected and divided into combined group and conventional group according to different treatment plans,with 38 cases in each group.The conventional group was treated with quadruple therapy,and the combined group was treated with digestive endoscopy on the basis of quadruple therapy.The therapeutic effect of the two groups was compared.Result:The amount of blood loss in the combined group was less than that in the conventional group,and the time of hemostasis and ulcer healing were earlier than those in the conventional group,the differences were statistically significant(P<0.05).After treatment,the thrombin time(TT),prothrombin time(PT),D-dimer(D-D)and international normalized ratio(INR)in the two groups were all lower than those before treatment,and the indexes in the combined group were lower than those in the conventional group,the differences were statistically significant(P<0.05).Before treatment,there was no significant difference in gastrin-17 level between the two groups(P>0.05).After treatment,the levels of gastrin-17 in both groups were higher than those before treatment,and the combined group was significantly higher than that in the conventional group,the differences were statistically significant(P<0.05).The total incidence of adverse reactions in combined group was lower than that in conventional group,and the difference was statistically significant(P<0.05).Conclusion:The effect of quadruple therapy combined with digestive endoscopy in the treatment of PUB is exact,which can effectively improve the body's coagulation function,rapidly stop bleeding to reduce the amount of blood loss,low incidence of adverse reactions,and high safety.