目的 觀察奧曲肽聯(lián)合雷貝拉唑治療非靜脈曲張性上消化道出血的臨床療效,為非靜脈曲張性上消化道出血的治療提供借鑒。方法 選取在2010年4月到2013年6月以來(lái)西安市第九醫(yī)院就診的非靜脈曲張性上消化道出血患者為研究對(duì)象,并根據(jù)治療方式隨機(jī)分為3組,奧曲肽組、雷貝拉唑組和聯(lián)合組,觀察患者臨床療效、生命體征、出血停止時(shí)間。結(jié)果 3組患者連續(xù)治療5 d后,出血時(shí)間奧曲肽組為(28±6)h,雷貝拉唑組為(26±5)h,聯(lián)合組為(20±5)h,雷貝拉唑組短于奧曲肽組,聯(lián)合組短于單獨(dú)用藥組,差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。血紅蛋白奧曲肽組、雷貝拉唑組、聯(lián)合組分別為(99±15)、(103±16)、(115±11)g/L,聯(lián)合組與其他兩組比較差異顯著(P<0.05)。聯(lián)合組患者白細(xì)胞明顯下降,下降程度明顯高于奧曲肽組和雷貝拉唑組,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。聯(lián)合組臨床癥狀改善情況明顯優(yōu)于奧曲肽組和雷貝拉唑組,黑便、嘔血、發(fā)熱病例數(shù)明顯減少,差異有統(tǒng)計(jì)學(xué)意義(P<0.05)?？傆行时容^,奧曲肽組為65.0%,雷貝拉唑組為85.0%,兩組比較差異有顯著性(P<0.05),聯(lián)合組總有效率為97.5%,與奧曲肽組、雷貝拉唑組比較,差異均有顯著性(P<0.05)。治療過(guò)程中聯(lián)合組1例患者出現(xiàn)輕微惡心、嘔吐癥狀,單藥組患者無(wú)不良反應(yīng)發(fā)生。結(jié)論 治療非靜脈曲張性上消化道出血,雷貝拉唑臨床療效優(yōu)于奧曲肽,奧曲肽聯(lián)合雷貝拉唑可明顯增強(qiáng)止血效果。

Objective To investigate the clinical efficacy of Octreotide combined with Rabeprazole in treatment of non-variceal gastrointestinal bleeding, in order to provide references for non-variceal gastrointestinal bleeding. Methods The patients with non-variceal gastrointestinal bleeding from April 2010 to June 2013 in The Ninth Hospital of Xi'an City were chosen and divided into three groups, such as Octreotide group, Rabeprazole group, and the combined group. The clinical symptoms, vital signs, bleeding stop time of three groups were observed. Results After treatment for 5 days, bleeding time in Octreotide group was (28 ± 6) h and (26 ± 5) h in Rabeprazole group and combined group (20 ± 5) h, Rabeprazole group is shorter than that of the octreotide group, the combined group was shorter than that of single drug group, the difference has statistical significance (P < 0.05). Hemoglobin in octreotide group, rabeprazole group and combination group were (99 ± 15), (103 ± 16), (115 ± 11) g/L respectively, combined group and the other two groups had significant difference (P < 0.05). The improvement of clinical symptoms of the combined group was obviously better than that of the Octreotide group and Rabeprazole group, melena, hematemesis, fever cases reduced significantly, the difference was statistically significant (P < 0.05). Comparison of total efficiency, Octreotide group was 65.0%, rabeprazole group was 85.0%, the difference between the two groups is significant (P < 0.05), total efficiency of combined group was 97.5%, compared with Octreotide group, Rabeprazole group, the differences were significantly (P < 0.05). During the course of treatment, 1 cases of patients with mild nausea and vomiting symptoms, no adverse reactions occurred in the single drug group. Conclusion In the treatment of non variceal upper gastrointestinal bleeding, Rabeprazole is superior to the clinical efficacy of Octreotide, the combined application of Octreotide and Rabeprazole can significantly enhance the hemostatic effect.