目的 探讨氨基己酸联合雷尼替丁治疗上消化道出血的临床疗效。方法 选取2019年9月-2021年9月商丘市立医院收治的106例上消化道出血患者,按照随机数字表法分为对照组和治疗组,每组各53例。对照组静脉滴注盐酸雷尼替丁注射液,50 mg加入0.9%氯化钠注射液250mL中稀释后缓慢静滴,1次/d。治疗组在对照组治疗基础上静脉滴注氨基己酸注射液,4 g加入5%葡萄糖注射液100 mL中稀释静滴,1次/d。两组患者连续治疗7d。观察两组的临床疗效,比较两组临床症状好转时间、凝血指标和血清学指标。结果 治疗后,治疗组总有效率是98.11%,显著高于对照组的81.13%(P<0.05)。治疗后,治疗组患者出现呕血、黑便、贫血、发热等症状好转时间均显著短于对照组(P<0.05)。治疗后,两组血小板(PLT)、纤维蛋白原(FIB)指标均较治疗前显著升高,而凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)显著缩短(P<0.05);治疗后,治疗组凝血指标改善优于对照组(P<0.05)。治疗后,两组血清炎症因子白细胞介素1β(IL-1β)、白细胞介素6(IL-6)、皮质醇(Cor)、肿瘤坏死因子-α(TNF-α)均较治疗前显著降低(P<0.05);治疗后,治疗组血清因子水平显著低于对照组(P<0.05)。结论 氨基己酸联合雷尼替丁治疗上消化道出血具有较好的临床疗效,止血效果显著,可改善凝血及炎症反应,值得临床推广与使用。

Objective To explore the clinical study of aminocaproic acid combined with ranitidine in treatment of upper gastrointestinal hemorrhage. Methods A total of 106 patients with upper gastrointestinal bleeding admitted to Shangqiu Municipal Hospital from September 2019 to September 2021 were selected and divided into control group and treatment group according to random number table method, with 53 cases in each group. Patients in the control group were iv administered with Ranitidine Hydrochloride Injection, 50 mg was diluted into 250 mL 0.9% sodium chloride injection and then dropped slowly, once daily. Patients in the treatment group were iv administered with Aminocaproic Acid Injection, 4 g was diluted into 5% glucose injection 100 mL for intravenous drip, once daily. Both groups were treated for 7 d. The clinical efficacy of the two groups were observed, and the improvement time of clinical symptoms, coagulation indexes and serological indexes were compared between the two groups. Results After treatment, the total effective rate in the treatment group was 98.11%, significantly higher than that in the control group (81.13%, P < 0.05). After treatment, the improvement time of hematemesis, melena, anemia, fever and other symptoms in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, platelet (PLT) and fibrinogen (FIB) indexes in two groups were significantly increased compared with before treatment, while prothrombin time (PT) and activated partial thrombin time (APTT) were significantly decreased (P < 0.05). After treatment, the coagulation index of the treatment group was better than that of the control group (P < 0.05). After treatment, serum interleukin-1 β (IL-1β), interleukin-6 (IL-6), cortisol (Cor) and tumor necrosis factor -α (TNF-α) in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the level of serum factor in treatment group was significantly lower than that in control group (P < 0.05). Conclusion Aminocaproic acid combined with ranitidine has good clinical effect in treatment of upper gastrointestinal hemorrhage with remarkable hemostatic effect, and can improve coagulation and inflammatory reaction, which is worthy of clinical promotion and use.

R975