奥曲肽辅助奥美拉唑治疗上消化道出血的临床效果观察

Clinical observation of omeprazole combined with octreotide in the treatment of upper gastrointestinal bleeding

目的:探析奥曲肽辅助奥美拉唑治疗上消化道出血(Upper gastrointestinal bleeding,UGIB)的临床效果和安全性。方法:选取2018年7月至2022年7月期间本院收治的80例UGIB患者作为研究对象。采用随机数字表法将患者分为观察组和对照组,各40例。对照组使用奥美拉唑静脉推注和输注治疗,观察组在对照组基础上接受奥曲肽静脉推注和泵注辅助治疗,两组均治疗7 d。分析对比两组临床相关指标、治疗前后的凝血指标(血小板计数(Platelet count,PLT)、纤维蛋白原(Fibrinogen,FIB))、肾功能指标(血尿素氮(Blood urea nitrogen,BUN)、血肌酐(Serum creatinine,Scr))以及不良反应,并治疗结束后随访1 y,比较两组复发率。结果:观察组的成功止血时间、肠鸣音恢复时间以及住院时间均显著短于对照组(P<0.05)。治疗后,两组的PLT、FIB水平均升高,且观察组的PLT、FIB水平均显著高于对照组(P<0.05)。治疗后,两组的BUN、Scr水平均较治疗前降低,且观察组的BUN、Scr水平均显著低于对照组(P<0.05)。治疗期间,两组的不良反应发生率无显著差异(P>0.05)。随访期间,观察组复发率低于对照组(P<0.05)结论:奥曲肽辅助奥美拉唑治疗UGIB,能改善患者的凝血功能,短时间内达到止血效果,促进患者胃肠功能及肾功能的恢复,且安全性较高,复发风险有所降低。

Objective:To investigate the clinical efficacy and safety of omeprazole combined with octreotide in the treatment of upper gastrointestinal bleeding(UGIB).Methods:80 UGIB patients admitted to our hospital from July 2018 to July 2022 were selected as the study objects.The patients were divided into observation group and control group with 40 cases in each group by random number table method.The control group received intravenous injection and infusion of omeprazole for treatment,while the observation group received intravenous injection and pump assisted treatment of octreotide on the basis of the control group.Both groups were treated for 7 days.Clinical related indexes,coagulation indexes[platelet count(PLT),fibrinogen(FIB)],renal function indexes[blood urea nitrogen(BUN),serum creatinine(Scr)]and adverse reactions of the two groups were analyzed and compared.The patients were followed up for 1 year after treatment,and the recurrence rates of the two groups were compared.Results:The observation group had significantly shorter successful hemostasis time,bowel sound recovery time,and hospital stay compared to the control group(P<0.05).After treatment,the levels of PLT and FIB in both groups increased,and the PLT and FIB levels in the observation group were significantly higher than those in the control group(P<0.05).After treatment,the levels of BUN and Scr in both groups decreased compared to before treatment,and the BUN and Scr levels in the observation group were significantly lower than those in the control group(P<0.05).During the treatment period,there was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).During the follow-up period,the recurrence rate in the observation group was lower than that in the control group(P<0.05)Conclusion:Octreotide assisted omeprazole in the treatment of UGIB can improve the coagulation function of patients,achieve hemostatic effects in a short period of time,promote the recovery of gastrointestinal and renal functions,and have high safety,while reducing the risk of recurrence.