三联疗法治疗ICU重症患者并发上消化道出血的效果分析  

Analysis effect of Triple Therapy in treatment of ICU patients with upper gastrointestinal bleeding

作　　者：袁宽道 田瑞兆[1] 王莉[1] 张丽丽 YUAN Kuandao;TIAN Ruizhao;WANG Li;ZHANG Lili(Department of Intensive Care Medicine,Gansu Cancer Hospital,Lanzhou,Gansu 730050,China)

机构地区：[1]甘肃省肿瘤医院重症医学科,甘肃兰州730050

出　　处：《医药前沿》2022年第16期4-6,共3页Journal of Frontiers of Medicine

摘　　要：目的:探讨兰索拉唑+奥曲肽+凝血酶三联疗法治疗ICU重症患者并发上消化道出血的效果。方法:选取2016年1月—2021年8月在我院ICU治疗的80例重症患者并发上消化道出血病例,根据随机数字表法分为两组,每组40例。对照组使用常规抑酸、止血治疗,观察组使用兰索拉唑+奥曲肽+凝血酶三联疗法治疗,对比两组的临床疗效、各项临床治疗指标、并发症发生率、病死率及Hb水平变化情况。结果:观察组治疗总有效率高于对照组(P<0.05);观察组止血时间、ICU住院时间均短于对照组,出血量少于对照组,输血率、再出血率均低于对照组,差异均有统计学意义(P<0.05);两组弥散性血管内凝血、多脏器功能衰竭、肝功能损伤、白细胞减少等并发症总发生率比较,差异无统计学意义(P>0.05);观察组病死率显著低于对照组(P<0.05);观察组发病时Hb水平与对照组比较,差异无统计学意义(P>0.05);但观察组治疗后24、48、72h的Hb水平显著高于对照组(P<0.05)。结论:ICU重症患者并发上消化道出血使用兰索拉唑+奥曲肽+凝血酶三联疗法的治疗效果显著,有助于提高止血效果,减少出血量,缩短治疗时间,加快Hb的恢复速度,降低病死率,对改善患者预后有积极的意义。Objective To analyze effect of Lansoprazole+Octreotide+Thrombin triple therapy in the treatment of ICU severe patients complicated with upper gastrointestinal bleeding.Methods A total of 80 severe patients with upper gastrointestinal bleeding treated in ICU of our hospital from January 2016 to August 2021 were randomly divided into two groups,with 40 cases in each group.The control group was treated with conventional acid suppression and hemostasis,and the observation group was treated with Lansoprazole+Octreotide+Thrombin triple therapy.The clinical efficacy,treatment indexes,incidence of complications,mortality,and Hb level changes of the two groups were compared.Results The effective rate of the observation group was higher than that of the control group(P<0.05).The hemostasis time and ICU stay in the observation group were lower than those in the control group,the bleeding volume was less than that in the control group,and the blood transfusion rate and rebleeding rate were lower than those in the control group(P<0.05).The mortality of the observation group were significantly lower than that of the control group(P<0.05).The level of Hb in the observation group was similar to that in the control group(P>0.05),but the level of Hb in the treatment group at 24,48 and 72 h was significantly higher than that in the control group(P<0.05).Conclusion The triple therapy of Lansoprazole+Octreotide+Thrombin is effective in ICU severe patients complicated with upper gastrointestinal bleeding.It can improve the hemostatic effect,reduce the amount of bleeding,shorten the treatment time,accelerate the recovery of Hb,reduce the incidence of complications and mortality,and has positive significance in improving the prognosis of patients.

关 键 词：急危重症 上消化道出血 药物联合治疗 止血效果 并发症 

分 类 号：R573.2[医药卫生—消化系统]