泮托拉唑联合奥曲肽及血凝酶治疗老年急性上消化道出血的疗效及对患者血清D-二聚体、BUN/Cr值水平的影响  

Efficacy of pantoprazole combined with octreotide and hemagglutinin in the treatment of acute upper gastrointestinal bleeding in the elderly and its influence on levels of serum D-dimer and BUN/Cr

作　　者：张娜 高东 王艳妮 ZHANG Na;GAO Dong;WANG Yan-ni(Department of Internal Medicine,Yulin Hospital of Traditional Chinese Medicine,Yulin 719000,Shaanxi,CHINA)

机构地区：[1]榆林市中医医院内科,陕西榆林719000

出　　处：《海南医学》2022年第13期1638-1642,共5页Hainan Medical Journal

基　　金：陕西省中医药管理局科研课题(编号:2018-GJ-JC056)。

摘　　要：目的 观察泮托拉唑、奥曲肽、血凝酶三联药物治疗老年急性上消化道出血(UGIB)的效果,并探讨其对患者血清D-二聚体(D-D)、尿素氮(BUN)/肌酐(Cr)值影响。方法 回顾性分析2017年6月至2020年12月榆林市中医医院消化内科收治的95例老年急性UGIB患者的临床资料,根据治疗方案不同分为观察组52例和对照组43例,观察组患者采取泮托拉唑、奥曲肽、血凝酶三联药物治疗,对照组患者采取泮托拉唑联合血凝酶治疗,连续治疗1周。比较两组患者的临床疗效,以及入院后持续出血时间、出血量、血压稳定时间和治疗1周后的止血成功率;同时比较两组患者治疗前、治疗1周后的D-D、纤维蛋白原(FIB)、BUN、Cr、BUN/Cr水平和用药安全性。结果 观察组患者的治疗总有效率为96.15%,明显高于对照组的79.07%,差异有统计学意义(P<0.05);观察组患者入院后持续出血时间、持续出血量、血压稳定时间分别为(12.98±2.52) h、(207.82±52.68) mL、(2.62±0.77) d,明显短于或小于对照组的(19.18±5.84) h、(328.15±74.26) mL、(4.35±1.26) d,差异均有统计学意义(P<0.05);观察组患者治疗1周后止血成功率为98.08%,明显高于对照组的83.72%,差异有统计学意义(P<0.05);治疗1周后,两组患者D-D水平均较治疗前下降、FIB水平较治疗前升高,且观察组患者的D-D为(0.49±0.17) mg/L,明显低于对照组的(0.67±0.21) mg/L,FIB为(3.08±0.56) g/L,明显高于对照组的(2.74±0.52) g/L,差异均有统计学意义(P<0.05);治疗1周后,两组患者的BUN水平、BUN/Cr值均较治疗前下降,且观察组患者的BUN和BUN/Cr值分别为(3.64±0.72) mmol/L、11.26±2.74,明显低于对照组的(6.35±1.64) mmol/L、15.44±3.57,差异均有统计学意义(P<0.05);治疗期间两组患者均未见严重影响治疗的不良反应,观察组与对照患者的不良反应总发生率分别为9.62%、6.98%,差异无统计学意义(P>0.05)。结论 老年急性UGIB患者采取泮托拉唑、�Objective To observe the effect of triple drug therapy with pantoprazole,octreotide,and hemagglutinin in the treatment of acute upper gastrointestinal bleeding(UGIB)in the elderly,and to explore its influence on serum D-dimer(D-D)and blood urea nitrogen(BUN)/creatinine(Cr).Methods The clinical data of 95 elderly patients with acute UGIB treated in Department of Gastroenterology,Yulin Hospital of Traditional Chinese Medicine were retrospectively analyzed between June 2017 and December 2020.According to different treatment regimens,the patients were divided into an observation group(52 cases)and a control group(43 cases).The patients in the observation group were given triple drug therapy of pantoprazole,octreotide,and hemagglutinin,and the patients in the control group were treated with pantoprazole combined with hemagglutinin,both continuously for 1 week.The clinical efficacy,continuous bleeding time,bleeding amount,and blood pressure stabilization time after admission,and success rate of hemostasis after 1 week of treatment were compared between the two groups.The levels of D-D,fibrinogen(FIB),BUN,Cr,BUN/Cr before treatment and after 1 week of treatment,and safety of medication were compared betweeen the two groups.Results The total effective rate of treatment in the observation group was significantly higher than that in the control group(96.15%vs 79.07%,P<0.05).The continuous bleeding time,continuous bleeding amount,and blood pressure stabilization time were(12.98±2.52)h,(207.82±52.68)mL,and(2.62±0.77)d in the observation group after admission,significantly shorter or less than(19.18±5.84)h,(328.15±74.26)mL,and(4.35±1.26)d in the control group(P<0.05).The success rate of hemostasis after 1 week of treatment was significantly higher in the observation group than that in the control group(98.08%vs 83.72%,P<0.05).After 1 week of treatment,the level of D-D in the two groups was decreased,while the level of FIB was increased compared to that before treatment(P<0.05);the D-D level in the observation group was

关 键 词：急性上消化道出血 老年人 泮托拉唑 奥曲肽 血凝酶 尿素氮/肌酐值 

分 类 号：R573.2[医药卫生—消化系统]