注射用艾司奥美拉唑钠联合生长抑素和凝血酶治疗消化性溃疡出血的疗效观察

摘要

Objective To observe the curative effect of Esomeprazole sodium combined with Somatostatin and Thrombin in the treatment of peptic ulcer bleeding (PUB) and to explore its clinical value.Method 194 patients with PUB in PLA Army General Hospital from June 2014 to June 2016 were selected for the study, they were randomly divided into observation group and control group, 97 cases in each group. All patients were treated with Esomeprazole sodium intravenous injection, observation group patients were treated with intravenous infusion of Somatostatin and Thrombin injection tube. Observed the changes of hemostasis time, hospitalization days, Blatchford scores, clinical curative effects, adverse reactions and blood routine and coagulation indexes before and after treatment between the two groups, and compared the safety and efficacy of the two therapeutic schemes.Result The bleeding time and hospitalization days of observation group were significantly shorter than those of control group (P<0.05). 72 hours after treatment, the Blatchford scores of the two goups were decreased significantly compared with before treatment (P<0.05), observation group decreased more significantly (P<0.05). The total effective rate of observation group was significantly higher than that of control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Compared with before treatment, the levels of hemoglobin, red blood cell counts, platelet counts, hematocrit and the levels of fibrinogen of the two groups increased significantly (P<0.05), white blood cell counts, prothrombin time and activated partial thromboplastin time shortened significantly (P<0.05), the above indexes of observation group changed more significantly than control group (P<0.05).Conclusion Esomeprazole sodiumcombined with Somatostatin and Thrombin in the treatment of PUB, can guarantee the safety of medication, shorten the bleeding time, improve the clinical efficacy. It's safety and effectiveness are worthy of recognition.%目的 观察注射用艾司奥美拉唑钠联合生长抑素和凝血酶治疗消化性溃疡出血(peptic ulcer bleeding,PUB)的疗效,探讨其临床价值.方法 选取中国人民解放军陆军总医院2014年6月至2016年6月收治的194例PUB患者为研究对象,按照随机数表法将入选患者分为观察组和对照组,每组各97例.两组患者均接受艾司奥美拉唑钠静脉注射,观察组患者加用生长抑素静脉泵入和凝血酶胃管注入.观察两组患者止血时间、住院天数、治疗前后Blatchford评分、临床疗效、不良反应发生情况及治疗前后血常规和凝血指标,比较两种治疗方案的安全性和有效性.结果 观察组患者止血时间和住院天数均显著短于对照组(P<0.05);两组患者治疗72小时后Blatchford评分较治疗前均显著下降(P<0.05),观察组患者下降更显著(P<0.05).观察组患者临床总有效率显著高于对照组(P<0.05),两组患者不良反应发生率比较无显著差异(P>0.05).与治疗前相比,两组患者治疗72小时后血红蛋白水平、红细胞计数、血小板计数、血细胞比容及纤维蛋白原水平均显著升高(P<0.05),白细胞计数、凝血酶原时间及活化部分凝血活酶活时间均显著缩短(P<0.05),观察组患者上述指标较对照组变化更显著(P<0.05).结论 艾司奥美拉唑钠联合生长抑素和凝血酶治疗PUB,能够在保证用药安全性的前提下,缩短出血时间,提高临床疗效,其安全性和有效性值得肯定.