高剂量生长抑素、奥美拉唑联合止血芳酸治疗急性上消化道出血合并凝血功能障碍患者的临床效果

目的:探讨高剂量生长抑素、奥美拉唑联合止血芳酸治疗急性上消化道出血合并凝血功能障碍患者的临床效果及安全性。方法:选择我院2014年1月~2017年12月收治的92例急性上消化出血合并凝血功能障碍的患者,并按随机数表法将其分为对照组和研究组。对照组予以常规剂量生长抑素、奥美拉唑联合止血芳酸治疗,研究组予以高剂量生长抑素治疗,其余奥美拉唑及止血芳酸用法同对照组。治疗后,比较两组的临床疗效、止血情况、住院时间,治疗前后血常规指标、凝血功能的变化及并发症的发生情况。结果:治疗后,研究组总有效率明显高于对照组[91.30%vs.74.42%](P0.05),而平均止血时间、再止血率及住院时间均明显短于对照组(P0.05);两组白细胞计数(WBC)、部分活化凝血酶原时间(APTT)及凝血酶原时间(PT)均较治疗前明显下降,血红蛋白(Hb)、红细胞计数(RBC)、红细胞压积(Hct)及血小板计数(PLT)均较治疗前明显上升,且研究组以上指标变化较对照组更明显(P0.05)。两组并发症的发生率比较差异均无统计学意义(P0.05)。结论:高剂量生长抑素、奥美拉唑联合止血芳酸治疗急性上消化道出血合并凝血功能障碍的效果明显优于常规剂量生长抑素、奥美拉唑联合止血芳酸治疗,其能够更有效缩短止血时间,避免再出血,且未增加药物不良反应,安全性高。

Clinical Effect of High Dose Somatostatin, Omeprazole Combined with Hemostasis on the Acute Upper Gastrointestinal Bleeding Patients combined with Coagulation Dysfunction

ABSTRACT Objective: To research the clinical effect and safety of high dose somatostatin, omeprazole combined with hemostasis on the acute upper gastrointestinal bleeding patients combined with coagulation dysfunction. Methods: 92 patients of acute upper gastrointestinal bleeding patients combined with coagulation dysfunction from January 2014 to December 2017. According to random number table method, thoes patients were divided into control group and research group, control group was treated with conventional dose somatostatin and omeprazole combined with hemostasis, and the research group was treated with high doses of somatostatin, and the remaining omeprazole and hemostasis were used the same as control group. After treatment, then clinical efficacy, hemostasis and hospitalization time, blood routine index, coagulation function before and after treatment, and complications between two group was compared. Results: After treatment, total effective rate in research group was obvious higher than control group (91.30% vs 74.42%) (P<0.05). While the average hemostatic time, rehemostasis rate and hospitalization time in research group were lesser than the control group (P<0.05). White blood cells (WBC), partial activation thrombin time (APTT) and prothrombin time (PT) were decreased than before treatment, hemoglobin (Hb), erythrocyte count (RBC), hematocrit (Hct) and platelet count (PLT) in both group were increased than before treatment, while the changes of the above indicators in the research group were more significant than those in the control group (P<0.05). Complication rate between the two groups was no statistically significant difference (P>0.05). Conclusion: Clinical effect of high dose somatostatin, omeprazole combined with hemostasis on the acute upper gastrointestinal bleeding patients combined with coagulation dysfunction is better than conventional dose somatostatin and omeprazole combined with hemostasis, can shorten the bleeding time, to avoid rebleeding, and did not increase the adverse drug reactions, high safety.