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目的观察奥曲肽联合雷贝拉唑治疗非静脉曲张性上消化道出血的临床疗效,为非静脉曲张性上消化道出血的治疗提供借鉴。方法选取在2010年4月到2013年6月以来西安市第九医院就诊的非静脉曲张性上消化道出血患者为研究对象,并根据治疗方式随机分为3组,奥曲肽组、雷贝拉唑组和联合组,观察患者临床疗效、生命体征、出血停止时间。结果 3组患者连续治疗5 d后,出血时间奥曲肽组为(28±6)h,雷贝拉唑组为(26±5)h,联合组为(20±5)h,雷贝拉唑组短于奥曲肽组,联合组短于单独用药组,差异具有统计学意义(P<0.05)。血红蛋白奥曲肽组、雷贝拉唑组、联合组分别为(99±15)、(103±16)、(115±11)g/L,联合组与其他两组比较差异显著(P<0.05)。联合组患者白细胞明显下降,下降程度明显高于奥曲肽组和雷贝拉唑组,差异有统计学意义(P<0.05)。联合组临床症状改善情况明显优于奥曲肽组和雷贝拉唑组,黑便、呕血、发热病例数明显减少,差异有统计学意义(P<0.05)。总有效率比较,奥曲肽组为65.0%,雷贝拉唑组为85.0%,两组比较差异有显著性(P<0.05),联合组总有效率为97.5%,与奥曲肽组、雷贝拉唑组比较,差异均有显著性(P<0.05)。治疗过程中联合组1例患者出现轻微恶心、呕吐症状,单药组患者无不良反应发生。结论治疗非静脉曲张性上消化道出血,雷贝拉唑临床疗效优于奥曲肽,奥曲肽联合雷贝拉唑可明显增强止血效果。
Objective To observe the clinical efficacy of octreotide combined with rabeprazole in the treatment of non-variceal upper gastrointestinal bleeding for the treatment of non-variceal upper gastrointestinal bleeding provide a reference. Methods The patients with non-variceal upper gastrointestinal bleeding who visited the Ninth Hospital of Xi’an from April 2010 to June 2013 were selected and divided into three groups at random: octreotide group, rabeprazole Group and the combined group, observe the clinical efficacy of patients, vital signs, bleeding time to stop. Results After 5 days of continuous treatment in 3 groups, the bleeding time was (28 ± 6) h in octreotide group and (26 ± 5) h in rabeprazole group, (20 ± 5) h in rabeprazole group, Shorter than octreotide, the combined group was shorter than the single drug group, the difference was statistically significant (P <0.05). The hemoglobin octreotide and rabeprazole groups were (99 ± 15), (103 ± 16) and (115 ± 11) g / L, respectively. The combined group was significantly different from the other two groups (P <0.05). The combined group of patients with leukocyte decreased significantly, the degree of decline was significantly higher than octreotide and rabeprazole group, the difference was statistically significant (P <0.05). The improvement of clinical symptoms in the combination group was significantly better than the octreotide and rabeprazole groups. The number of melena, hematemesis and fever decreased significantly (P <0.05). The total effective rate was 65.0% in the octreotide group and 85.0% in the rabeprazole group, with a significant difference between the two groups (P <0.05). The total effective rate in the combined group was 97.5% The difference was significant (P <0.05). During the course of treatment, 1 patient in the combined group showed slight nausea and vomiting, and no adverse reactions occurred in the single drug group. Conclusion The treatment of non-variceal upper gastrointestinal bleeding, rabeprazole clinical efficacy is better than octreotide, octreotide combined with rabeprazole can significantly enhance the hemostatic effect.