奥曲肽联合奥美拉唑治疗非曲张静脉上消化道出血疗效观察.docVIP

奥曲肽联合奥美拉唑治疗非曲张静脉上消化道出血疗效观察 　 作者：陈雄 徐灿霞 王芬 李宏韬 【摘要】 目的 观察奥曲肽联合奥美拉唑治疗非曲张静脉上消化道出血的疗效。方法 将143例非曲张静脉上消化道出血患者，包括消化性溃疡、急性胃黏膜病变、胃癌、肝硬化门脉高压性胃出血等，随机分为A组（83例）和B组（60例），A组为奥曲肽联合奥美拉唑组，B组为单用奥美拉唑组，观察两组的止血效果。结果 A组24 h止血显效率为81.93%，明显高于B组（61.67%），P＜0.01；止血时间为（20.53±5.46）h，短于B组［（28.96±5.95）h］，输血量为（1.02±0.56）u，少于B组［（2.52±0.53）u］，48 h再出血率为1.20％，低于B组（8.33％），均Plt;0.05。结论 奥曲肽联合奥美拉唑治疗非曲张静脉上消化道出血有显著疗效，较单用奥美拉唑有止血速度快、输血量减少、早期再出血发生率低的特点。 【关键词】 奥美拉唑 奥曲肽；非曲张静脉 上消化道出血 ［Abstract］ Objective To observe the efficacy of octreotide combined with omeprazole versus omeprazole alone in non-variceal upper gastrointestinal hemorrhage.Methods One hundred and forty-three cases of non-variceal upper gastrointestinal hemorrhage,consist of peptic ulcer,acute gastric mucosal lesion,gastric carcinoma,liver cirrhosis with portal hypertensive gastropathy，were assigned to two groups: group A （83 cases）and group B（60 cases）.Group A received octreotide plus omeprazole，while group B was treated with omeprazole alone.Results The effective ratio of group A was significantly higher than that of group B（81.93% vs 61.67%,Plt;0. 01）；The haemostasis time of group A was shorter than that of group B （20.53±5.46 h vs 28.96±5.95 h，Plt;0. 05）,the blood transfusion requirement and the rebleeding rate after the first 48 hours of group A （1.02±0.56 u and 1.20％）was less than that of group B （2.52±0.53 u and 8.33％）,Plt; 0. 05.Conclusion The combination of octreotide and omeprazole infusion is more effective than omeprazole alone in non-variceal upper gastrointestinal hemorrhage，it can lead to speeder up haemostasis pacing,fewer blood transfusion requirements and prevent early rebleeding effectively. ［Key words］ omeprazole;octreotide;non-variceal;upper gastrointestinal hemorrhage 上消化道出血是临床上常见的内科急重症，病因复杂，病情危重。迅速有效的止血是治疗的关键。现就我院近期非曲张静脉上消化道出血患者应用奥曲肽联合奥美拉唑进行疗效观察，现报告如下。 1 资料与方法 1.1 一般资料 2005年1月～2006年7月收治的143例上消化道出血患者，症状为呕血和（或）黑便，均经胃镜证实为非曲张静脉上消化道出血，分为A、B两组，A组为奥曲肽联合奥美拉唑治疗组（n=83），男71例，女12例，平均年龄（52.1±6.3）岁，病因包括消化性溃疡39例、急性胃黏膜病变11例、胃癌6例、门脉高压性胃病