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目的:探讨鼻饲云南白药加奥曲肽治疗丘脑区脑卒中并发应激性上消化道出血的效果。方法:将58例临床确诊为丘脑区脑卒中并发应激性上消化道出血的患者随机分为治疗组(n=29)和对照组(n=29),对照组在常规脑卒中治疗的基础上采用奥曲肽首次0.1 mg静脉注射,然后采用0.025 mg/h的速度进行72~96 h的持续静脉滴注;治疗组在对照组的基础上,加用0.5 g云南白药鼻饲,每4 h鼻饲1次。观察两组的止血时间、止血效果和上消化道出血相关死亡率。结果:治疗组和对照组并发上消化道出血相关性死亡率分别为3.5%和20.7%,组间差异有统计学意义(P<0.05);患者平均止血时间治疗组为(26.7±6.4)h,对照组为(45.3±4.4)h,组间差异有统计学意义(P<0.05);治疗组和对照组大便潜血转阴时间分别为(36.7±4.2)h、(76.8±6.1)h,组间差异有统计学意义(P<0.05);转阴率分别为96.0%和76.2%,组间差异有统计学意义(P<0.05)。结论:鼻饲云南白药加奥曲肽治疗丘脑区卒中并发应激性上消化道出血疗效确切。
Objective: To investigate the effect of nasal feeding Yunnanbaiyao plus octreotide in the treatment of stress-induced upper gastrointestinal hemorrhagic stroke in the thalamus. Methods: Fifty-eight patients with clinically diagnosed as thalamic stroke complicated with stress upper gastrointestinal bleeding were randomly divided into treatment group (n = 29) and control group (n = 29). The control group was treated on the basis of conventional stroke On the basis of the control group, plus 0.5 g Yunnan Baiyao nasal feeding, every 4 h of nasal feeding 1, the use of intravenous injection of 0.1 mg octreotide for the first time, and then continuous intravenous infusion of 0.025 mg / h for 72-96 h; Times. Hemostatic time, hemostatic effect and upper gastrointestinal bleeding related mortality in both groups were observed. Results: The mortality rates of upper gastrointestinal bleeding in treatment group and control group were 3.5% and 20.7%, respectively, with significant difference (P <0.05). The average hemostasis time in treatment group was (26.7 ± 6.4) h , And the control group was (45.3 ± 4.4) h, the difference between the two groups was statistically significant (P <0.05); the fecal occult blood negative conversion time in the treatment group and the control group were (36.7 ± 4.2) h and (76.8 ± 6.1) The difference between the two groups was statistically significant (P <0.05). The negative conversion rates were 96.0% and 76.2% respectively. There was significant difference between the two groups (P <0.05). Conclusion: Nasopharyngeal Baiyao plus octreotide is effective in the treatment of thalamic stroke complicated with stress upper gastrointestinal bleeding.