氨甲环酸联合沙利度胺治疗小肠血管畸形出血的疗效观察  

作　　者：方诗洁 顾凌飞 ZULQARNAIN MUHAMMAD 凌丽倩 刘方舟 吕冰冰 吕文[3] 

机构地区：[1]浙江中医药大学第四临床医学院,310053 [2]杭州市第九人民医院,311200 [3]浙江大学医学院附属杭州市第一人民医院,310000

出　　处：《浙江临床医学》2023年第5期710-712,共3页Zhejiang Clinical Medical Journal

摘　　要：目的探讨氨甲环酸联合沙利度胺治疗小肠血管畸形引起消化道出血的疗效。方法选取2018年10月至2020年1月小肠血管畸形引起消化道出血患者78例,采用随机数字表法分为观察组1、观察组2和对照组,每组各26例。观察组1口服氨甲环酸联合沙利度胺治疗,观察组2口服沙利度胺治疗,对照组给予生长抑素治疗,比较3组患者用药1周、2周、1个月、6个月后血红蛋白、大便常规、不良反应及再出血率。结果3组患者经相同时间治疗后,血红蛋白均较治疗前明显上升(P<0.05),相同时间点观察组1患者血红蛋白均较其他两组高(P<0.05),观察组1患者粪便隐血转阴时间较其他两组提前,观察组1患者再出血率较其他两组低。结论氨甲环酸联合沙利度胺可早期改善小肠血管畸形引起的出血,达到早期快速止血的效果,安全性高,值得临床推广应用。Objective To explore the efficacy of tranexamic acid combined with thalidomide in the treatment of gastrointestinal bleeding caused by small intestinal vascular malformation to achieve early rapid and safe hemostasis.Methods A total of 78 patients with gastrointestinal bleeding caused by small intestinal vascular malformation admitted to the Gastroenterology Department of our hospital from October 2018 to January 2020 were selected as the observation objects.They were divided into the observation group 1,2 and the control group by random number table method,with 26 cases in each group.The observation group 1 was treated with oral tranexamic acid combined with thalidomide,the observation group 2 was treated with oral thalidomide,and the control group was treated with somatostatin.The changes of hemoglobin,stool routine,adverse reactions and rebleeding rate after 1 week,2 weeks,1 month and 6 months of treatment were compared among the 3 groups.Results At the same time,the hemoglobin of patients in the observation group 1 was higher than that in the other two groups,with statistical significance(P<0.05),the time of fecal occult blood turning negative was earlier than that in the other two groups,with statistical significance(P<0.05),and the rebleeding rate in the observation group 1 was lower than that in the other two groups.At the same time point,the hemoglobin of patients in the observation group 1 was higher than that in the other two groups,with statistical significance(P<0.05).The time of fecal occult blood turning to negative in the observation group 1 was earlier than that in the other two groups(P<0.05),and the rebleeding rate of patients in the observation group 1 was lower than that in the other two groups.Conclusion Tranexamic acid combined with thalidomide can early improve the bleeding caused by small intestinal vascular malformation,and achieve the effect of early rapid hemostasis.It has high safety and is worthy of clinical application.

关 键 词：氨甲环酸 沙利度胺 小肠血管畸形 疗效 

分 类 号：R574[医药卫生—消化系统]