兰索拉唑、奥曲肽、血凝酶联用治疗老年急性上消化道出血80例临床观察

目的探讨兰索拉唑、奥曲肽、血凝酶联用治疗老年急性上消化道出血临床疗效。方法将2008年1月至2013年4月于深圳市南湾人民医院住院治疗的160例老年急性上消化道出血患者按数字表法随机分为两组,每组80例,观察组采用兰索拉唑60 mg静脉滴注,每日1次,奥曲肽0.1 mg溶于0.9%氯化钠溶液20 mL,以0.025 mg/h的速度持续静脉滴注72 h,血凝酶1000 U静脉推注,每日2次;治疗组采用奥曲肽、血凝酶两种药物联合应用,用法同观察组,比较两组患者的临床疗效和平均显效时间。结果观察组临床疗效优于治疗组（u=2.0569,P〈0.05）,平均显效时间观察组为（6.12±1.34）h,治疗组为（9.56±2.64）h,观察组优于治疗组（t=9.788,P〈0.05）;治疗后两组患者肝、肾功能和心电图均未出现波动,在治疗期间,观察组出现头痛1例、恶心2例,治疗组出现腹胀1例,均经对症处理后症状消失。结论联合应用兰索拉唑、奥曲肽、血凝酶治疗老年急性上消化道出血疗效确切,安全性高,可作为优选治疗方案。

Clinical Observation of Lansoprazole,Octreotide,Blood Coagulation Enzyme Treatment of Acute Upper Gastrointestinal Hemorrhage in 80 Cases

Objective To investigate the effect of lansoprazole,octreotide,combined blood coagulation enzyme in the treatment of elderly patients with acute upper gastrointestinal hemorrhage. Methods One hundred and sixty elder patients with acute upper gastrointestinal hemorrhage hospitalized in Nanwan People＇s Hospital in Shenzhen City from Jan. 2008 to Apr. 2013 were randomly divided into two groups according to number table,80 cases in each group,the observation group was treated with intravenous dripslansoprazole 1 time/d,octreotide 0. 1 mg dissolved in 20 mL 0. 9% sodium chloride solution,with the speed of 0. 025 mg/h continuous infusion for 72 h,hemocoagulase 1000 U intravenous injection,2 time/d; the treatment group was treated with octreotide and hemocoagulase with the same method as the observation group, and the clinical effect and the average onset time of the two groups were compared. Results The clinical effect of observation group was better than that of the treatment group（ u = 2. 0569,P 0. 05）,the average onset time of the observation group was（ 6. 12 ± 1. 34） h,of the treatment was（ 9. 56 ± 2. 64） h,the observation group was better than the treatment group（ t = 9. 788,P 0. 05）; the hepatorenal function and cardiogram of two groups after treatment were not fluctuate,during the treatment,there was 1 case of nausea,2 cases of headache in the observationt group,1 case of abdominal distension in the treatment group,while all of the symptoms disappeared after symptomatic treatment. Conclusion Combined lansoprazole,octreotide,hemocoagulase therapy in elder patients with acute upper gastrointestinal hemorrhage,has affirmative effect and high safety,which can be used as a preferred treatment.