[1]吴忠军,林 涛,胡 彬.兰索拉唑、奥曲肽、凝血酶三联治疗重症上消化道出血的临床疗效及并发症观察[J].医学信息,2021,34(24):64-67.[doi:10.3969/j.issn.1006-1959.2021.24.013]
　WU Zhong-jun,LIN Tao,HU Bin.Clinical Effects and Complications of Lansoprazole, Octreotide and Thrombin in the Treatment of Severe Upper Gastrointestinal Hemorrhage[J].Medical Information,2021,34(24):64-67.[doi:10.3969/j.issn.1006-1959.2021.24.013]
点击复制

兰索拉唑、奥曲肽、凝血酶三联治疗重症上消化道出血的临床疗效及并发症观察()
分享到：

医学信息[ISSN:1006-1959/CN:61-1278/R]

卷:
34卷
期数:
2021年24期
页码:
64-67
栏目:
论著
出版日期:
2021-12-15

文章信息/Info

Title:
Clinical Effects and Complications of Lansoprazole, Octreotide and Thrombin in the Treatment of Severe Upper Gastrointestinal Hemorrhage
文章编号:
1006-1959（2021）24-0064-04
作者:
吴忠军; 林 涛; 胡 彬
（上饶市广信区中医院重症ICU，江西 上饶 334100）
Author(s):
WU Zhong-jun; LIN Tao; HU Bin
(Intensive ICU,Shangrao Guangxin District Hospital of Traditional Chinese Medicine,Shangrao 334100,Jiangxi,China)
关键词:
上消化道出血; 胃泌素; 兰索拉唑; 凝血酶; 奥曲肽; 炎性反应
Keywords:
Upper gastrointestinal hemorrhage; Gastrin; Lansoprazole; Thrombin; Octreotide; Inflammatory reaction
分类号:
R573.2
DOI:
10.3969/j.issn.1006-1959.2021.24.013
文献标志码:
A
摘要:
目的 观察兰索拉唑、奥曲肽、凝血酶三联治疗重症上消化道出血的临床疗效及并发症情况。方法 选取2018年2月-2021年6月我院收治的60例重症上消化道出血患者，按照随机数字表法分为对照组与观察组，各30例。对照组应用兰索拉唑联合凝血酶治疗，观察组应用兰索拉唑、奥曲肽、凝血酶三联治疗，比较两组止血疗效、止血时间、输血量、再出血率、炎性应激指标[超敏-C反应蛋白（hs-CRP）、肿瘤坏死因子-α（TNF-α）、皮质醇（COR）]、胃液pH值、血清胃泌素水平、全血血红蛋白水平、并发症发生情况。结果 观察组止血总有效率为96.67%，高于对照组的80.00%，差异有统计学意义（P＜0.05）；观察组止血时间短于对照组，输血量、再出血率小于对照组，差异有统计学意义（P＜0.05）；观察组hs-CRP、TNF-α、COR水平低于对照组，差异有统计学意义（P＜0.05）；观察组胃液pH值、血红蛋白高于对照组，胃泌素水平低于对照组，差异有统计学意义（P＜0.05）；两组并发症总发生率比较，差异无统计学意义（P＞0.05）。结论 兰索拉唑、奥曲肽、凝血酶三联治疗重症上消化道出血疗效肯定，可缩短患者止血时间，减少输血量及再出血风险，缓解机体炎性应激反应，同时改善其胃液pH值及胃泌素、血红蛋白指标，且不增加并发症发生风险。
Abstract:
Objective To observe the clinical efficacy and complications of lansoprazole, octreotide and thrombin in the treatment of severe upper gastrointestinal hemorrhage.Methods Sixty patients with severe upper gastrointestinal hemorrhage admitted to our hospital from February 2018 to June 2021 were selected and randomly divided into the control group and the observation group, with 30 cases in each group. The control group was treated with lansoprazole combined with thrombin, and the observation group was treated with lansoprazole, octreotide and thrombin. The hemostatic efficacy, hemostatic time, blood transfusion volume, rebleeding rate, inflammatory stress indexes [high sensitivity-C reactive protein (hs-CRP), tumor necrosis factor-α (TNF-α), cortisol (COR)], gastric pH value, serum gastrin level, whole blood hemoglobin level, and complications were compared between the two groups.Results The total effective rate of hemostasis in the observation group was 96.67%, which was higher than 80.00% in the control group, and the difference was statistically significant (P<0.05). The hemostasis time of the observation group was shorter than that of the control group, and the amount of blood transfusion and rebleeding rate were less than those of the control group, the difference was statistically significant (P<0.05). The levels of hs-CRP, TNF-α and COR in the observation group were lower than those in the control group, and the difference was statistically significant (P<0.05). The gastric juice pH value and hemoglobin in the observation group were higher than those in the control group, and the gastrin level was lower than that in the control group, the difference was statistically significant (P<0.05). There was no significant difference in the total incidence of complications between the two groups (P>0.05).Conclusion The triple combination of lansoprazole, octreotide and thrombin has a positive effect in the treatment of severe upper gastrointestinal hemorrhage, which can shorten the time of hemostasis, reduce the amount of blood transfusion and the risk of rebleeding, alleviate the body’s inflammatory stress response, and improve the gastric juice pH value, gastrin and hemoglobin indicators, and do not increase the risk of complications.

参考文献/References:

[1]许文君.三联疗法联合生长抑素对Hp阳性消化性溃疡合并上消化道出血的临床疗效及对炎性因子的影响研究[J].中国医药指南,2021,19(23):4-6.[2]张媛.兰索拉唑奥曲肽凝血酶三联治疗ICU重症并发上消化道出血的临床研究[J].泰山医学院学报,2020,41(2):132-133.[3]朱小龙,郭伟新,连丹.三联用药治疗ICU重症并发上消化道出血临床分析[J].黑龙江医药,2019,32(5):1061-1063.[4]李鹏程,严启荣.ICU重症并发上消化道出血的治疗及预后评定[J].中国继续医学教育,2019,11(24):69-71.[5]吴家圣,廖梅嫣,曾汇霞.ICU重症并发上消化道出血患者应用兰索拉唑联合奥曲肽治疗的效果观察[J].中国现代药物应用,2019,13(10):98-100.[6]汤仕龙.凝血酶、生长抑素联合奥美拉唑治疗上消化道出血的临床分析[J].赣南医学院学报,2018,38(12):1212-1213,1216.[7]Poddar U.Diagnostic and therapeutic approach to upper gastrointestinal bleeding[J].Paediatr Int Child Health,2019,39(1):18-22.[8]黄少辉,苏立勇.重症上消化道出血患者给予兰索拉唑凝血酶奥曲肽联合保守治疗效果观察[J].黑龙江医学,2017,41(11):1068-1069.[9]葛昀.泮托拉唑防治急危重症患者消化道出血的临床价值分析[J].海峡药学,2019,31(2):165-166.[10]Wang X,Liu Y,Zhao J,et al.Clinical efficacy of octreotide acetate combined with thrombin in the treatment of liver cirrhosis complicated with gastrointestinal hemorrhage[J].Exp Ther Med,2019,17(5):3417-3422.[11]张艳杰,冯春,刘红,等.大剂量埃索美拉唑治疗急性非静脉曲张性上消化道出血的临床疗效和安全性分析[J].中国实用医药,2017,12(36):129-130.[12]Shamliyan TA,Middleton M,Borst C.Patient-centered Outcomes with Concomitant Use of Proton Pump Inhibitors and Other Drugs[J].Clinical Therapeutics,2017,39(2):404-427.[13]常旭.兰索拉唑治疗消化道溃疡上消化道出血的综合疗效观察[J].中国实用医药,2016,11(34):129-130.[14]范红侠,吕良山.奥美拉唑联合血凝酶对胃溃疡伴上消化道出血的疗效[J].西南国防医药,2017,27(7):711-714.[15]Ali-Mohamad N,Cau M,Baylis J,et al.Severe upper gastrointestinal bleeding is halted by endoscopically delivered self-propelling thrombin powder: A porcine pilot study[J].Endoscopy International Open,2021,9(5):E693-E698.[16]杨熹,宋冬梅,华敏.生长抑素联合奥曲肽治疗肝硬化并发上消化道出血患者疗效及其对凝血功能指标的影响再观察[J].实用肝脏病杂志,2020,23(5):695-698.[17]Riha HM,Wilkinson R,Twilla J,et al.Octreotide Added to a Proton Pump Inhibitor Versus a Proton Pump Inhibitor Alone in Nonvariceal Upper-Gastrointestinal Bleeds[J].Ann Pharmacother,2019,53(8):794-800.[18]宋奇峰,周建波,桑建忠,等.奥曲肽联合奥美拉唑治疗肝硬化上消化道出血的疗效观察[J].中国生化药物杂志,2016,36(8):127-129.[19]季永胜,李譞.泮托拉唑联合奥曲肽治疗重症非静脉曲张性上消化道出血疗效观察[J].吉林医学,2015,36(17):3760-3762.[20]施乾坤,王翔,郑曙云.兰索拉唑奥曲肽凝血酶三联治疗ICU重症并发上消化道出血的疗效观察[J].现代消化及介入诊疗,2016,21(1):144-145.[21]Kogawa K,Ando T,Fujiwara M.Successful use of long-acting octreotide for protracted gastrointestinal bleeding related to protein-losing enteropathy after the Fontan procedure: a case report[J].Cardiol Young,2021,31(8):1333-1335.[22]蒋公安.ICU重症并发上消化道出血行兰索拉唑奥曲肽凝血酶三联治疗的效果探究[J].系统医学,2018,3(10):54-56.[23]Abrishami M,Peymani P,Zare M,et al.The Effect of Octreotide in Acute Nonvariceal Upper Gastrointestinal Bleeding: A Randomized, Double-Blind, Placebo-Controlled Trial[J].J Res Pharm Pract,2020,9(2):94-100.[24]蔚梅芳.艾司奥美拉唑、血凝酶联合生长抑素对急性上消化道出血患者血清hs-CRP、TNF-α、COR水平的影响[J].临床医学工程,2020,27(7):915-916.[25]朱丰胜.影响消化性溃疡合并上消化道出血的相关因素研究[J].现代诊断与治疗,2016,27(8):1491-1492.[26]梁凯.三联疗法治疗急性上消化道出血的临床疗效与安全性分析[J].中国处方药,2016,14(12):63-64.

相似文献/References:

[1]高 颖.消化内镜下局部药物联合去甲肾上腺素治疗 上消化道出血的疗效观察[J].医学信息,2018,31(10):104.[doi:10.3969/j.issn.1006-1959.2018.10.032]
　GAO Ying.Clinical Observation of Digestive Endoscopy Combined with Norepinephrine in the Treatment of Upper Gastrointestinal Bleeding[J].Medical Information,2018,31(24):104.[doi:10.3969/j.issn.1006-1959.2018.10.032]
[2]陈艳玲.内镜下止血术联合奥曲肽治疗上消化道出血的临床效果[J].医学信息,2022,35(11):141.[doi:10.3969/j.issn.1006-1959.2022.11.037]
　CHEN Yan-ling.Clinical Effect of Endoscopic Hemostasis Combined with Octreotide in the Treatment of Upper Gastrointestinal Bleeding[J].Medical Information,2022,35(24):141.[doi:10.3969/j.issn.1006-1959.2022.11.037]
[3]张宏程.生长抑素联合泮托拉唑治疗肝硬化合并上消化道出血的疗效观察[J].医学信息,2019,32(03):153.[doi:10.3969/j.issn.1006-1959.2019.03.050]
　ZHANG Hong-cheng.Therapeutic Effect of Somatostatin Combined with Pantoprazole on Hepatic Cirrhosis Complicated with Upper Gastrointestinal Hemorrhage[J].Medical Information,2019,32(24):153.[doi:10.3969/j.issn.1006-1959.2019.03.050]
[4]高华初.泮托拉唑治疗消化性溃疡合并上消化道出血的临床价值评价[J].医学信息,2018,31(22):153.[doi:10.3969/j.issn.1006-1959.2018.22.045]
　GAO Hua-chu.Clinical Value of Pantoprazole in the Treatment of Peptic Ulcer Complicated with Upper Gastrointestinal Bleeding[J].Medical Information,2018,31(24):153.[doi:10.3969/j.issn.1006-1959.2018.22.045]
[5]何志钧,梁运啸,梁列新.质子泵抑制剂治疗上消化道出血对痛风复发的影响[J].医学信息,2019,32(01):154.[doi:10.3969/j.issn.1006-1959.2019.01.048]
　HE Zhi-jun,LIANG Yun-xiao,LIANG Lie-xin.Effect of Proton Pump Inhibitor on Upper Gastrointestinal Hemorrhage on Recurrence of Gout[J].Medical Information,2019,32(24):154.[doi:10.3969/j.issn.1006-1959.2019.01.048]
[6]张许林,余泽波.肝硬化上消化道出血的输血治疗进展[J].医学信息,2019,32(08):85.[doi:10.3969/j.issn.1006-1959.2019.08.025]
　ZHANG Xu-lin,YU Ze-bo.Progress in Transfusion Therapy for Upper Gastrointestinal Hemorrhage[J].Medical Information,2019,32(24):85.[doi:10.3969/j.issn.1006-1959.2019.08.025]
[7]周佳美,张晓娟,王明蕾,等.上消化道出血住院患者临床特征分析[J].医学信息,2019,32(16):116.[doi:10.3969/j.issn.1006-1959.2019.16.037]
　ZHOU Jia-mei,ZHANG Xiao-juan,WANG Ming-lei,et al.Analysis of Clinical Features of Hospitalized Patients with Upper Gastrointestinal Bleeding[J].Medical Information,2019,32(24):116.[doi:10.3969/j.issn.1006-1959.2019.16.037]
[8]何金龙.射血分数降低心力衰竭患者血清G-17水平检测及其意义[J].医学信息,2022,35(17):49.[doi:10.3969/j.issn.1006-1959.2022.17.011]
　HE Jin-long.Detection of Serum G-17 Level in Heart Failure Patients with Reduced Ejection Fraction and its Significance[J].Medical Information,2022,35(24):49.[doi:10.3969/j.issn.1006-1959.2022.17.011]
[9]黄 飞.不同用药方案治疗幽门螺杆菌感染胃溃疡的效果比较[J].医学信息,2020,33(16):156.[doi:10.3969/j.issn.1006-1959.2020.16.050]
　HUANG Fei.Comparison of the Effects of Different Medication Regimens in the Treatment of Gastric Ulcer Infected by Helicobacter Pylori[J].Medical Information,2020,33(24):156.[doi:10.3969/j.issn.1006-1959.2020.16.050]
[10]李光明,曾军红,郭香莲.奥曲肽联合泮托拉唑治疗老年消化性溃疡合并上消化道出血的疗效及对凝血功能和炎症因子的影响[J].医学信息,2022,35(22):99.[doi:10.3969/j.issn.1006-1959.2022.22.020]
　LI Guang-ming,ZENG Jun-hong,GUO Xiang-lian.Efficacy of Octreotide Combined with Pantoprazole in the Treatment of Elderly Peptic Ulcer Complicated with Upper Gastrointestinal Hemorrhage and its Effect on Coagulation Function and Inflammatory Factors[J].Medical Information,2022,35(24):99.[doi:10.3969/j.issn.1006-1959.2022.22.020]

更新日期/Last Update: 1900-01-01