曲洪兰

【摘要】 目的：探討奥曲肽联合甲氰咪胍对上消化道出血患者不良反应发生与出血量的影响。方法：选取2017年6月-2019年10月入住本院的上消化道出血患者62例，根据治疗方式不同分为两组，各31例。对照组仅采用甲氰咪胍治疗，研究组采用奥曲肽联合甲氰咪胍治疗，比较两组治疗效果、不良反应率、出血量、心理状态及生存质量变化情况。结果：研究组治疗总有效率高于对照组，差异有统计学意义（P<0.05）。两组不良反应率比较，差异无统计学意义（P>0.05）。治疗后24、48、72 h，研究组出血量均低于研究组，差异均有统计学意义（P<0.05）。治疗后，研究组SAS、SDS评分均低于对照组，差异均有统计学意义（P<0.05）。治疗后，研究组生存质量各项评分均高于对照组，差异均有统计学意义（P<0.05）。结论：在治疗上消化道出血患者的过程中，采用奥曲肽联合甲氰咪胍的治疗效果显著，可在临床上进一步推广与应用。

【关键词】 奥曲肽 甲氰咪胍 上消化道出血 出血量

Effect of Octreotide Combined with Cimetidine on the Occurrence of Adverse Reactions and the Amount of Bleeding in Patients with Upper Gastrointestinal Hemorrhage/QU Honglan. //Medical Innovation of China， 2021， 18（07）： 0-068

[Abstract] Objective： To investigate the effect of Octreotide combined with Cimetidine on the occurrence of adverse reactions and the amount of bleeding in patients with upper gastrointestinal hemorrhage. Method： A total of 62 patients with upper gastrointestinal bleeding admitted to our hospital from June 2017 to October 2019 were divided into two groups， according to different treatment methods， 31 cases in each group. The control group was only treated with Cimetidine， while the study group was treated with Octreotide combined with Cimetidine. The therapeutic effect， the probability of adverse reactions， the bleeding volume， the psychological state and the change of quality of life of the two groups were compared. Result： The total effective rate of the study group was higher than that of the control group， the difference was statistically significant （P<0.05）. Adverse reaction rate was compared， there was no significant difference between the two groups （P>0.05）. 24， 48 and 72 h after treatment， the amount of blood loss in the study group was lower than that in the study group， the differences were statistically significant （P<0.05）. After treatment， SAS and SDS scores in the study group were lower than those in the control group， the difference were statistical significance （P<0.05）. After treatment， the scores of life quality in the study group were all higher than those in the control group， the difference were statistical significance （P<0.05）. Conclusion： In the treatment of upper gastrointestinal bleeding patients， Octreotide combined with Cimetidine has a significant effect， which can be further promoted and applied in clinical.

[Key words] Octreotide Cimetidine Upper gastrointestinal bleeding Blood loss

First-authors address： Hunnan District Central Hospital， Shenyang 110015， China

doi：10.3969/j.issn.1674-4985.2021.07.016

人体消化系统中，最常见的一种病症就是上消化道出血。上消化道出血主要指的是屈氏韧带以上消化道病症引发的出血，主要临床表现为急性且大量出血，主要病因为非静脉曲张性出血，常见病症包括胃炎、胃肠道溃疡等，若患者未得到及时有效的治疗将严重影响其生命健康[1]。相关研究指出，上消化道出血患者的死亡率为7%～14%，属于消化系统急危重症[2]。由此可见，对于上消化道出血患者来说予以及时有效的治疗，控制其出血量，避免疾病复发具有重要意义[3]。目前临床治疗上消化道出血的方式仍为内科保守治疗，奥曲肽可选择性减少机体内脏循环的血流量，属于人工合成生长抑素，甲氰咪胍属于组胺H2受体阻滞剂，可对食物、组胺、胃泌素等导致的胃酸分泌，同时还能减少氢离子浓度及胃液分泌量，上述两种药物在治疗上消化道出血方面具有显著效果[4-5]。……