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目的探讨注射用尖吻蝮蛇血凝酶联合注射用奥美拉唑钠治疗急性非静脉曲张上消化道出血的临床疗效。方法选取2013年6月—2015年1月商洛市中心医院收治的急性非静脉曲张上消化道出血的患者94例,依据治疗方案随机分为对照组和治疗组,每组各47例。对照组静脉滴注注射用奥美拉唑钠,40 mg溶于100 m L葡萄糖溶液中,2次/d。治疗组在对照组基础上静脉推注注射用尖吻蝮蛇血凝酶,1 U溶于20 m L生理盐水中,2次/d。两组均连续治疗5 d。观察两组的临床疗效,比较两组治疗前后临床症状和血红蛋白(Hb)水平。结果治疗后,对照组和治疗组的总有效率分别为82.90%、95.70%,两组比较差异具有统计学意义(P<0.05)。治疗后,治疗组的止血时间、输血量、住院时间、再出血率明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者Hb水平均明显升高,同组治疗前后差异具有统计学意义(P<0.05);且治疗组Hb水平的升高程度明显优于对照组,两组比较差异具有统计学意义(P<0.05)。两组患者不良反应均较为轻微,统计学差异不明显。结论注射用尖吻蝮蛇血凝酶联合注射用奥美拉唑钠治疗急性非静脉曲张上消化道出血具有较好的临床疗效,止血速度快,安全性高,不良反应低,值得临床推广使用。
Objective To investigate the clinical efficacy of injection of Agkistrodon halysii combined with omeprazole sodium in the treatment of acute non-varices upper gastrointestinal bleeding. Methods From June 2013 to January 2015, 94 patients with acute non-varices upper gastrointestinal bleeding admitted to Shangluo Central Hospital were randomly divided into control group and treatment group according to the treatment plan, 47 cases in each group. The control group was omeprazole sodium for intravenous injection, 40 mg dissolved in 100 m L glucose solution, 2 times / d. On the basis of the control group, the treatment group was intravenously injected with Agkistrodon cholerae acuminase, and 1 U was dissolved in 20 mL normal saline twice a day. Both groups were treated for 5 consecutive days. The clinical effects of the two groups were observed. The clinical symptoms and hemoglobin (Hb) level were compared between the two groups before and after treatment. Results After treatment, the total effective rate of the control group and the treatment group were 82.90% and 95.70%, respectively, with significant difference between the two groups (P <0.05). After treatment, the bleeding time, blood transfusion, hospital stay and rebleeding rate in the treatment group were significantly better than those in the control group. The difference between the two groups was statistically significant (P <0.05). After treatment, the levels of Hb in both groups were significantly increased, the difference between the two groups was statistically significant (P <0.05), and the level of Hb in the treatment group was significantly higher than that in the control group, the difference between the two groups was statistically significant Significance (P <0.05). Adverse reactions in both groups were minor, the statistical difference was not obvious. Conclusion Injection of Agkistrodon halysii Coagulation combined with omeprazole sodium for the treatment of acute non-variceal upper gastrointestinal bleeding has good clinical efficacy, rapid bleeding, high safety, low adverse reactions, it is worthy of clinical promotion .