血凝酶与生长抑素联合质子泵抑制剂治疗急性上消化道出血的临床效果及对机体炎性反应的影响
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摘要
目的观察血凝酶与生长抑素联合质子泵抑制剂治疗急性上消化道出血的临床效果及对机体炎性反应的影响。方法选取2015年4月—2017年7月我院接受治疗的134例急性上消化道出血患者,根据治疗方式的不同分为观察组与对照组各67例,对照组患者给予基础治疗+奥美拉唑钠静脉滴注,观察组患者在对照组治疗基础上加用血凝酶与生长抑素治疗,两组患者均连续治疗3～4 d。比较两组患者临床效果,止血时间及住院时间,治疗前后血清超敏-C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)及皮质醇(COR)水平,以及治疗期间不良反应发生情况。结果观察组患者治疗后临床总有效率为92.54%高于对照组的73.13%,差异有统计学意义(P<0.01)。治疗后,观察组患者止血时间、住院时间均明显短于对照组患者,差异均有统计学意义(P<0.05或P<0.01)。治疗后,两组患者血清hs-CRP、TNF-α与COR水平明显低于治疗前,且治疗后观察组患者上述指标水平亦明显低于对照组患者,差异均有统计学意义(P<0.05或P<0.01)。两组患者治疗期间总不良反应发生率比较差异无统计学意义(P>0.05)。结论血凝酶与生长抑素联合质子泵抑制剂治疗急性上消化道出血的临床效果肯定,可缩短患者止血时间及住院时间,缓解机体应激反应,明显改善炎性反应程度,且安全性较好。
Objective To investigate the clinical effect of hemocoagulase and somatostatin combined with proton pump inhibitor in the treatment of acute upper gastrointestinal bleeding(AUGIB) and its influence on inflammatory response of the body. Methods A total of 134 cases with AUGIB who were treated in our hospital from April 2015 to July 2017 were selected. According to the different treatment methods, they were divided into the observation group and the control group, with 67 cases in each group. The control group was given Omeprazole sodium intravenously as the basic treatment. The patients in the observation group were treated with hemagglutinase and somatostatin on the basis of the control group. Both patients were treated continuously for 3 to 4 d. Clinical effects, the hemostatic time and average length of hospital stay were analyzed and compared in both groups. In addition, the levels of hs-CRP, TNF-α and COR were detected, and the adverse reactions during the treatment were observed. Results The total effective rate after treatment in the observation group(92.54%) was significantly higher than that in the control group(73.13%), and the difference between the two groups was statistically significant(P<0.01). After treatment, the hemostatic time and length of hospital stay in the observation group were significantly shorter than those in the control group, and there were significant differences between the two groups(P<0.05 or P<0.01). After treatment, serum levels of hs-CRP, TNF-α and COR of the two groups were significantly lower than those before treatment, and the levels of the above indicators in the observation group after treatment was also significantly lower than that in the control group, suggesting significant difference(P<0.05 or P<0.01). There was no significant difference in the incidence of total adverse reactions between the two groups(P>0.05). Conclusion Hemagglutinase and somatostatin combined with proton pump inhibitors have a favorable clinical effect in the treatment of AUGIB, which can shorten hemostatic time and length of hospitalization of patients, relieve the body's stress response, and significantly improve the degree of inflammatory reaction. Furthermore, it is good in safety.
Objective To investigate the clinical effect of hemocoagulase and somatostatin combined with proton pump inhibitor in the treatment of acute upper gastrointestinal bleeding(AUGIB) and its influence on inflammatory response of the body. Methods A total of 134 cases with AUGIB who were treated in our hospital from April 2015 to July 2017 were selected. According to the different treatment methods, they were divided into the observation group and the control group, with 67 cases in each group. The control group was given Omeprazole sodium intravenously as the basic treatment. The patients in the observation group were treated with hemagglutinase and somatostatin on the basis of the control group. Both patients were treated continuously for 3 to 4 d. Clinical effects, the hemostatic time and average length of hospital stay were analyzed and compared in both groups. In addition, the levels of hs-CRP, TNF-α and COR were detected, and the adverse reactions during the treatment were observed. Results The total effective rate after treatment in the observation group(92.54%) was significantly higher than that in the control group(73.13%), and the difference between the two groups was statistically significant(P<0.01). After treatment, the hemostatic time and length of hospital stay in the observation group were significantly shorter than those in the control group, and there were significant differences between the two groups(P<0.05 or P<0.01). After treatment, serum levels of hs-CRP, TNF-α and COR of the two groups were significantly lower than those before treatment, and the levels of the above indicators in the observation group after treatment was also significantly lower than that in the control group, suggesting significant difference(P<0.05 or P<0.01). There was no significant difference in the incidence of total adverse reactions between the two groups(P>0.05). Conclusion Hemagglutinase and somatostatin combined with proton pump inhibitors have a favorable clinical effect in the treatment of AUGIB, which can shorten hemostatic time and length of hospitalization of patients, relieve the body's stress response, and significantly improve the degree of inflammatory reaction. Furthermore, it is good in safety.
引文
[1] 蒲应香,邢成文,李玉鹏,等.血凝酶及生长抑素联合奥美拉唑治疗急性上消化道出血的临床疗效及安全性[J].中国中西医结合消化杂志,2016,24(2):150-152.
[2] 黄杨清,曾志明,罗海强.生长抑素联合蛇毒血凝酶和安胃疡治疗老年上消化道出血疗效比较[J].海南医学,2017,28(22):3712-3713.
[3] 张逸强,宋红杰,王振东.尖吻蝮蛇血凝酶联合生长抑素和埃索美拉唑治疗上消化道出血的疗效观察[J].现代药物与临床,2017,32(3):455-459.
[4] 萧树东.理论与实践相融合的佳作--评《实用消化病学》[J].中华消化杂志,2001,21(4):232.
[5] 周青梅,付晓林,乔强.蛇毒血凝酶及云南白药对非静脉曲张上消化道出血治疗效果及并发症的影响[J].中国中西医结合消化杂志,2016,24(8):620-622,626.
[6] 高成广,谢峰,冯亚东.生长抑素联合泮托拉唑治疗肝硬化合并上消化道出血的效果观察[J].临床肝胆病杂志,2016,32(2):284-287.
[7] Abente E J, Santos J, Lewis N S, et al. The Molecular Determinants of Antibody Recognition and Antigenic Drift in the H3 Hemagglutinin of Swine Influenza A Virus[J].J Virol, 2016,90(18):8266-8280.
[8] 邱博芸,章阳,韩思静.生长抑素联合泮托拉唑治疗急性上消化道出血及对患者血清超敏C反应蛋白的影响[J].标记免疫分析与临床,2017,24(7):786-788.
[9] 移军.两种质子泵抑制剂静注辅助常规对症干预对急性非静脉曲张性上消化道出血患者PCV、BUN水平及不良反应风险的影响[J].标记免疫分析与临床,2017,24(2):197-199.
[10] 凌伟华.白眉蛇毒血凝酶联合奥美拉唑治疗老年急性上消化道出血疗效及成本-效果分析[J].中国医师杂志,2017,19(10):1564-1566.
[11] 王二龙.泮托拉唑联合血凝酶治疗上消化道出血的疗效观察[J].北京医学,2017,39(1):105-106.
[12] 刘晓萍,白雪峰.泮托拉唑联合生长抑素治疗食管胃底静脉曲张性上消化道出血的临床疗效观察[J].药物评价研究,2016,39(5):844-847.
[13] 刘韬滔,何清,冯喆.重组活化凝血因子Ⅶa在腹部手术后难治性大出血的疗效研究[J].四川医学,2018,39(1):68-71.
[14] Caygur A, Albaba M R, Berberoglu A, et al. Efficacy of glycine powder air-polishing combined with scaling and root planing in the treatment of periodontitis and halitosis: A randomised clinical study[J]. J Int Med Res, 2017,45(3):1168-1174.
[15] 刘海珊,符照康,李永超,等.内镜下钛夹与质子泵抑制剂联合治疗Dieulafoy溃疡并上消化道出血的效果观察[J].实用临床医药杂志,2017,21(13):107-108.
[16] 黄伟,黄翔,方量.益气止血方联合质子泵抑制剂治疗非静脉曲张性上消化道出血的疗效观察[J].安徽医药,2017,21(3):554-557.
[17] 马刚,郭娟.生长抑素联合乌司他丁治疗消化道出血的临床疗效及其对炎症因子的影响[J].临床和实验医学杂志,2016,15(11):1081-1083.
[18] 刘晓.血凝酶联合奥美拉唑治疗急性非静脉曲张上消化道出血的临床研究[J].现代药物与临床,2016,31(8):1193-1196.
[19] 严明科,鲍磊,王迎新,等.白眉蛇毒血凝酶联合泮托拉唑在上消化道出血患者中的作用机制研究[J].海南医学院学报,2017,23(3):345-348,352.
[20] 聂军,吴伟民.生长抑素与泮托拉唑联合凝血酶治疗急性上消化道出血的疗效分析[J].中国药房,2016,27(33):4656-4658.
[2] 黄杨清,曾志明,罗海强.生长抑素联合蛇毒血凝酶和安胃疡治疗老年上消化道出血疗效比较[J].海南医学,2017,28(22):3712-3713.
[3] 张逸强,宋红杰,王振东.尖吻蝮蛇血凝酶联合生长抑素和埃索美拉唑治疗上消化道出血的疗效观察[J].现代药物与临床,2017,32(3):455-459.
[4] 萧树东.理论与实践相融合的佳作--评《实用消化病学》[J].中华消化杂志,2001,21(4):232.
[5] 周青梅,付晓林,乔强.蛇毒血凝酶及云南白药对非静脉曲张上消化道出血治疗效果及并发症的影响[J].中国中西医结合消化杂志,2016,24(8):620-622,626.
[6] 高成广,谢峰,冯亚东.生长抑素联合泮托拉唑治疗肝硬化合并上消化道出血的效果观察[J].临床肝胆病杂志,2016,32(2):284-287.
[7] Abente E J, Santos J, Lewis N S, et al. The Molecular Determinants of Antibody Recognition and Antigenic Drift in the H3 Hemagglutinin of Swine Influenza A Virus[J].J Virol, 2016,90(18):8266-8280.
[8] 邱博芸,章阳,韩思静.生长抑素联合泮托拉唑治疗急性上消化道出血及对患者血清超敏C反应蛋白的影响[J].标记免疫分析与临床,2017,24(7):786-788.
[9] 移军.两种质子泵抑制剂静注辅助常规对症干预对急性非静脉曲张性上消化道出血患者PCV、BUN水平及不良反应风险的影响[J].标记免疫分析与临床,2017,24(2):197-199.
[10] 凌伟华.白眉蛇毒血凝酶联合奥美拉唑治疗老年急性上消化道出血疗效及成本-效果分析[J].中国医师杂志,2017,19(10):1564-1566.
[11] 王二龙.泮托拉唑联合血凝酶治疗上消化道出血的疗效观察[J].北京医学,2017,39(1):105-106.
[12] 刘晓萍,白雪峰.泮托拉唑联合生长抑素治疗食管胃底静脉曲张性上消化道出血的临床疗效观察[J].药物评价研究,2016,39(5):844-847.
[13] 刘韬滔,何清,冯喆.重组活化凝血因子Ⅶa在腹部手术后难治性大出血的疗效研究[J].四川医学,2018,39(1):68-71.
[14] Caygur A, Albaba M R, Berberoglu A, et al. Efficacy of glycine powder air-polishing combined with scaling and root planing in the treatment of periodontitis and halitosis: A randomised clinical study[J]. J Int Med Res, 2017,45(3):1168-1174.
[15] 刘海珊,符照康,李永超,等.内镜下钛夹与质子泵抑制剂联合治疗Dieulafoy溃疡并上消化道出血的效果观察[J].实用临床医药杂志,2017,21(13):107-108.
[16] 黄伟,黄翔,方量.益气止血方联合质子泵抑制剂治疗非静脉曲张性上消化道出血的疗效观察[J].安徽医药,2017,21(3):554-557.
[17] 马刚,郭娟.生长抑素联合乌司他丁治疗消化道出血的临床疗效及其对炎症因子的影响[J].临床和实验医学杂志,2016,15(11):1081-1083.
[18] 刘晓.血凝酶联合奥美拉唑治疗急性非静脉曲张上消化道出血的临床研究[J].现代药物与临床,2016,31(8):1193-1196.
[19] 严明科,鲍磊,王迎新,等.白眉蛇毒血凝酶联合泮托拉唑在上消化道出血患者中的作用机制研究[J].海南医学院学报,2017,23(3):345-348,352.
[20] 聂军,吴伟民.生长抑素与泮托拉唑联合凝血酶治疗急性上消化道出血的疗效分析[J].中国药房,2016,27(33):4656-4658.