奥曲肽治疗贲门粘膜撕裂综合征合并休克的效果研究  

Octreotide for mallory-weiss syndrome with shock

作　　者：杜绍安[1] 杜丽君[2] 

机构地区：[1]旺苍县人民医院内科,四川628200 [2]广元市第一人民医院

出　　处：《社区医学杂志》2013年第14期1-2,共2页Journal Of Community Medicine

摘　　要：目的探讨奥曲肽治疗贲门粘膜撕裂综合征合并休克的临床效果。方法选择2006年1月—2012年12月收治的贲门粘膜撕裂综合征患者55例,随机分为观察组27例和对照组28例,所有患者入院后均由其家属签署知情同意书,对照组使用止血药物、输氧、镇静、补充血容量并维持酸碱电解质平衡等处理。观察组在对照组的基础上使用奥曲肽注射液首先0.1 mg静脉推注(5min),随后以0.6 mg溶于5%葡萄糖注射液500 ml中,通过输液泵以50μg/h的速度连续静脉滴注,12h 1次,连续治疗5d。比较两组总住院时间、血淀粉酶转阴时间及治疗效果。计量资料比较使用t检验,组间率的比较采用χ2检验,P<0.05差异有统计学意义。结果观察组总住院时间[(8.5±2.1)d]显著短于对照组[(11.6±3.4)d],血淀粉酶转阴时间[(14.6±2.5)h]快于对照组[(35.4±5.8)h],两组比较差异均有统计学意义(t=4.050、17.151,P<0.05)。观察组总有效率92.6%,对照组67.9%,两组比较差异有统计学意义(χ2=5.256,P<0.05)。结论对于失血性休克昏迷患者,使用奥曲肽能较理想的降低患者胃内pH值,促进凝血,提高临床治疗效果,值得临床推广。Objective To investigate the clinical efficacy of octreotide for Mallory Weiss syndrome complicated with shock. Methods Fifty - five treated cases of Mallory - Weiss syndrome from January 2006 to December 2012 were randomly divided into two groups： observation group（27 cases） and control group（28 cases）. Family members of all patients signed informed consent on admission. Control group was treated with hemostatic drugs, oxygen delivery, sedation and sup- plement blood volume to maintain acid- base and electrolyte balance. In addition, octreotide was given to observation group, in which it was injected intravenously in a dose of 0. 1 mg （5 min） and then dissolved in 5% glucose injection 500 ml in a dose of 0.6 mg for continuous intravenous＇ infusion via the infusion pump at the speed of 50 μg/h, q12 h, for 5 consecutive days. And then both groups were compared for hospital stay, amylase clearance time and clinical efficacy. The t - test was used for measurement data, χ2 test for rate comparison between groups, and the result of P 〈 0.05 was consid- ered to be statistically significant. Results In observation group, the total hospital stay was （8.5 ± 2.1 ） d, which was shorter than that in control group （11.6 ±3.4） d; blood amylase clearance time was （14.6 ± 2.5） h, which was faster than that in control group （ 35.4 ± 5.8） h, and the difference between the two groups was statistically significant （ t = 4. 050, 17. 151, P 〈0. 05）. The total effective rate was 92.6% in observation group and 67.9% in contrel group, which showed significant difference. Conclusion For hemorrhagic shock and coma, the use of octreotide can better reduce gas- tric pH levels, promote blood clotting and improve clinical outcomes, so it is worthy of being applied in clinical practice.

关 键 词：奥曲肽 贲门粘膜撕裂综合征 休克 

分 类 号：R573.6[医药卫生—消化系统]