摘要
目的探讨奥曲肽联合不同剂量艾司奥美拉唑用于急性非静脉曲张性上消化道出血(ANVUGIB)患者的疗效和安全性。方法回顾性分析南康区第一人民医院2019年6月-2021年6月收治的143例急性非静脉曲张性上消化道出血患者的临床资料,按治疗方案中艾司奥美拉唑的不同剂量给药的方式将患者分为A组(69例,给予奥曲肽+大剂量艾司奥美拉唑)和B组(74例,给予奥曲肽+标准剂量艾司奥美拉唑),均治疗3d。比较两组治疗前后血清高敏C反应蛋白(hs-CRP)、血红蛋白(Hb)水平;比较治疗前胃pH值、用药后pH值达到6所需时间、pH≥6持续时间;比较治疗过程中总输血量、止血时间、72h内再出血率及不良反应发生率。结果A组、B组治疗总有效率分别为92.75%(64/69)和81.08%(60/74),差异具有统计学意义(P<0.05)。治疗过程中,两组患者的总输血量无显著性差异(P>0.05),止血时间A组显著短于B组(P<0.05);治疗后,两组患者的hs-CRP显著降低,pH、Hb显著升高,且A组hs-CRP水平相对更低,差异具有统计学意义(P<0.05);治疗前,两组患者胃pH值无显著性差异(P>0.05),治疗过程中,A组患者胃液pH值达到6所需时间显著更短(P<0.05),pH≥6持续时间无显著性差异(P>0.05);与B组比较,A组患者72h内再出血率更低(P<0.05),两组不良反应发生率无显著性差异(P>0.05)。结论大剂量艾司奥美拉唑联合奥曲肽用于治疗急性非静脉曲张性上消化道出血患者,可通过加快胃内pH值达到较高水平,缩短止血所需时间,降低再出血率,疗效更佳且不增加不良反应风险。
Objective To investigate the efficacy and safety of octreotide combined with different doses of Esomeprazole in patients with acute non variceal upper gastrointestinal bleeding(ANVUGIB).Methods The clinical data of 143 patients with acute non variceal upper gastrointestinal bleeding admitted to our hospital from June 2019 to June 2021 were analyzed retrospectively.The patients were divided into group A(69 cases,given octreotidethigh-dose esomeprazole)and group B(74 cases,given octreotide+standard dose esomeprazole)according to the different doses of esomeprazole in the treatment scheme,and were treated for 3 days.Serum high-sensitivity C-reactive protein(hs-CRP)and hemoglobin(Hb)before and after treatment were compared between the two groups;compare the pH before treatment,the time required for pH to reach 6 after treatment,and the duration of pH>6;the total transfusion volume,hemostasis time,rebleeding rate within 72 hours and adverse reaction rate were compared.Results The total effective rates of group A and B were 92.75%(64/69)and 81.08%(60/74),respectively,with a statistically significant difference(P<0.05).During the treatment,there was no significant difference in the total blood transfusion between the two groups(P>0.05),and the hemostatic time of group A was significantly shorter than that of group B(P<0.05);after treatment,the hs-CRP level in the two groups decreased significantly,pH and Hb increased significantly,and the hs-CRP level in group A was relatively lower,with a statistically significant difference(P<0.05);before treatment,there was no significant difference between the two groups in gastric pH before treatment(P<O.05).During the treatment,the time required for patients'gastric juice pH to reach 6 was significantly shorter(P<0.05),and there was no significant difference in the duration of pH>6<(P>0.05);compared with group B,the incidence of rebleeding within 72 hours in group A was lower(P<0.05),and there was no significant difference in the incidence of adverse reactions between the two grou
作者
李玉平
范华英
龚利平
Li Yuping;Fan Huaying;Gong Liping(The First People's Hospital of Nankang District,Ganzhou,Jiangxi 341400,China;Nankang Traditional Chinese Medicine Hospital,Ganzhou,Jiangxi 341400,China)
出处
《首都食品与医药》
2023年第9期77-80,共4页
Capital Food Medicine
