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[摘要]
目的 探讨注射用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临床疗效。方法 选取驻马店市中心医院2014年1月-2016年8月收治的上消化道出血患者80例,随机分为对照组和治疗组,每组各40例。对照组患者静脉泵注注射用生长抑素,3 mg加入生理盐水500 mL中,泵入速度40 mL/h,2次/d;同时静脉滴注注射用埃索美拉唑钠,40 mg加入生理盐水100 mL中,30 min内滴完,2次/d。治疗组患者在对照组的基础上静脉推注注射用尖吻蝮蛇血凝酶,1 U溶于20 mL生理盐水中,1次/d。两组均连续治疗5 d。比较两组患者治疗前后临床疗效、输血量、止血时间、血红蛋白(Hb)水平、凝血指标及再出血率。结果 治疗后,对照组的总有效率为80.00%,显著低于治疗组的95.00%,两组总有效率比较差异有统计学意义(P<0.05)。治疗后,治疗组患者输血量与止血时间均少于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组Hb水平均显著升高(P<0.05);且治疗组的Hb水平高于对照组(P<0.05)。治疗后,两组PT、APTT均显著缩短,同组治疗前后比较差异有统计学意义(P<0.05);且治疗后治疗组PT、APTT均短于对照组,两组比较差异具有统计学意义(P<0.05)。结论 注射用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可有效缩短止血时间、减少输血量,且利于血红蛋白水平的恢复,具有一定的临床推广应用价值。
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[Abstract]
Objective To investigate the clinical effect of Agkistrodon haemocoagulase combined with somatostatin and esomeprazole in treatment of upper gastrointestinal bleeding. Methods Patients (80 cases) with upper gastrointestinal bleeding in Zhumadian Central Hospital from January 2014 to August 2016 were randomly divided into control and treatment groups, and each group had 40 cases. Patients in the control group were administered with Somatostatin for injection by iv pump infusion, 3 mg added into 500 mL normal saline, and the speed was 40 mL/h, twice daily. the patients were iv administered with Esomeprazole Sodium for injection, 40 mg added into 100 mL normal saline, and the infusion time was less than 30 min, twice daily. Patients in the treatment group were iv administered with Haemocoagulase Agkistrodon for injection on the basis of control group, 1 U added into 20 mL normal saline, once daily. Patients in two groups were treated for 5 d. After treatment, the clinical efficacy, blood transfusion amount, hemostatic time, coagulation indexes, and rebleeding rate in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.00%, which was significantly lower than 95.00% in the treatment group, and there was difference between two groups (P<0.05). After treatment, blood transfusion amount and hemostatic time in treatment group were significantly shorter than those in the control group, with significant difference between two groups (P<0.05). After treatment, Hb levels in two groups were significantly increased (P<0.05). And Hb level in the treatment group was significantly higher than that in the control group (P<0.05). After treatment, PT and APTT in two groups were significantly shortened, and the difference was statistically significant in the same group (P<0.05). The PT and APTT in the treatment group were significantly shorter than those in the control group, with significant difference between two groups (P<0.05). Conclusion Agkistrodon haemocoagulase combined with somatostatin and esomeprazole in treatment of upper gastrointestinal bleeding can effectively shorten the hemostatic time and reduce the blood transfusion amount, and is conducive to Hb level recovery, which has a certain clinical application value.
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