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目的:探讨奥曲肽联合栓塞介入治疗消化性溃疡引发的上消化道出血的临床研究。方法:将30例消化道溃疡合并急性消化道大出血患者随机分为对照组和联合治疗组,每组15例,对照组患者采用栓塞介入治疗,联合治疗组采用奥曲肽联合栓塞治疗,在48 h后评价短期疗效,并随访1月观察患者的出血复发情况及不良反应;采用联合免疫试剂盒检测患者在治疗前及治疗后2天,3天和7天的大便隐血,并记录患者隐血转阴时间和住院时间。结果:联合治疗组患者的短期有效率为92.9%明显高于对照组的60.0%,且差异有统计学意义(X~2=8.96,P<0.05);治疗前,两组患者的大便隐血试验均为阳性,治疗2天后,联合治疗组和对照组的隐血阳性率分别为21.4%和66.7%,两组比较差异有显著意义(X~2=6.66,P<0.01);治疗3天后,联合治疗组92.8%患者隐血试验转阴,显著高于对照组60.0%,且差异有统计学意义(X~2=4.66,P<0.05);对照组患者的隐血转阴时间和住院时间分别为(4.15±2.37)天和(7.22±1.98)天高于联合治疗组,其隐血转阴时间和住院时间分别为(2.77±1.98)天和(5.33±2.07)天,两组相比,差异有统计学意义(P<0.05)。结论:奥曲肽联合栓塞介入治疗可以快速止血,再出血发生率低和安全等特点,能有效治疗消化性溃疡引发的急性上消化道大出血。
Objective: To investigate the clinical study of octreotide combined with embolization on upper gastrointestinal hemorrhage caused by peptic ulcer. Methods: Thirty patients with peptic ulcer complicated with acute gastrointestinal hemorrhage were randomly divided into control group and combination therapy group, 15 cases in each group. The control group was treated with embolization and the combination therapy group was treated with octreotide combined embolization. After 48 hours The short-term curative effect was evaluated and the recurrence of bleeding and adverse reactions were observed in January. Combined immunization kit was used to detect fecal occult blood before and 2 days, 3 days and 7 days after treatment. And hospital stay. Results: The short-term effective rate in the combined treatment group was 92.9%, which was significantly higher than that in the control group (60.0%, X 2 = 8.96, P 0. 05). Before the treatment, The positive rates of occult blood were 21.4% and 66.7% in the combined treatment group and control group respectively after 2 days of treatment. There was significant difference between the two groups (X ~ 2 = 6.66, P <0.01). After 3 days of treatment, The occult blood test was negative in 92.8% of the patients in the treatment group, which was significantly higher than that of the control group (60.0%) (X 2 = 4.66, P 0.05). The time of occult blood and hospital stay in the control group were 4.15 ± 2.37) days and (7.22 ± 1.98) days were higher than the combined treatment group, the concealed time and hospital stay were (2.77 ± 1.98) days and (5.33 ± 2.07) days respectively. There was statistically significant difference between the two groups Significance (P <0.05). Conclusion: The octreotide interventional embolization can quickly hemostasis, low bleeding rate and safety, which can effectively treat the acute upper gastrointestinal bleeding caused by peptic ulcer.