韩冰

【摘要】 目的：探讨生长抑素联合奥美拉唑治疗消化道出血患者的临床效果及对血清IL-2、IL-6、TNF-α水平的影响。方法：选取2018年9月-2020年9月于本院就诊的176例消化道出血患者，按照随机数字表法将其分为对照组和研究组，各88例。对照组使用奥美拉唑治疗，研究组使用生长抑素联合奥美拉唑治疗。比较两组住院时间、血红蛋白下降值、胃液pH值、黑便消失时间、呕血消失时间、临床疗效、不良反应、TNF-α、IL-6、IL-2水平变化情况。结果：研究组血红蛋白下降值低于对照组，住院时间、黑便及呕血消失时间均短于对照组，胃液pH值高于对照组，差异均有统计学意义（P<0.05）。研究组总有效率高于对照组，差异有统计学意义（P<0.05）。治療72 h后，两组TNF-α、IL-6水平均低于治疗前，IL-2水平均高于治疗前，且研究组TNF-α、IL-6水平均低于对照组，IL-2水平高于对照组，差异均有统计学意义（P<0.05）。两组不良反应发生率比较，差异无统计学意义（P>0.05）。结论：消化道出血患者使用生长抑素联合奥美拉唑治疗，效果确切安全，患者临床症状有明显缓解，止血速度更快，全身炎症反应可得到进一步抑制，可作为有价值的联合治疗方案推广使用。

【关键词】 消化道出血 奥美拉唑 生长抑素 胃液pH值

Clinical Effect of Somatostatin Combined with Omeprazole in the Treatment of Gastrointestinal Bleeding and Its Influence on Serum Levels of IL-2， IL-6 and TNF-α/HAN Bing. //Medical Innovation of China， 2021， 18（05）： 00-005

[Abstract] Objective： To investigate the effect of Somatostatin combined with Omeprazole on the clinical efficacy and serum levels of IL-2， IL-6 and TNF-α in patients with gastrointestinal bleeding. Method： A total of 176 patients with gastrointestinal bleeding admitted to our hospital from September 2018 to September 2020 were selected， they were divided into control group and study group according to random number table method， 88 patients in each group. The control group was treated with Omeprazole， the study group was treated with Somatostatin combined with Omeprazole. The hospitalization time， hemoglobin decrease value， gastric juice pH value， melena disappearance time， hematemesis disappearance time， clinical efficacy， adverse reactions， the changes of serum TNF-α， IL-6 and IL-2 were compared between the two groups. Result： The decrease value of hemoglobin in the study group was lower than that in the control group， the length of hospital stay， melena and hematemesis disappearance time were shorter than those in the control group， the pH value of gastric juice was higher than that in the control group， the differences were statistically significant （P<0.05）. The total effective rate of the study group was higher than that of the control group， the difference was statistically significant （P<0.05）. After 72 h treatment， the levels of TNF-α and IL-6 in both groups were lower than those before treatment， the levels of IL-2 in both groups were higher than those before treatment， the levels of TNF-α and IL-6 in the study group were lower than those of the control group， the level of IL-2 in the study group was higher than that of the control group， the differences were statistical significance （P<0.05）. There was no significant difference in the incidence of adverse reactions between the two groups （P>0.05）. Conclusion： Somatostatin combined with Omeprazole in the treatment of gastrointestinal bleeding is effective and safe， the clinical symptoms of the patients are significantly relieved， the hemostasis speed is faster， and the systemic inflammatory reaction can be further inhibited， which can be used as a valuable combination therapy.

[Key words] Gastrointestinal bleeding Omeprazole Somatostatin Gastric juice pH value

First-authors address： Liaoyang Central Hospital， Liaoyang 111000， China

doi：10.3969/j.issn.1674-4985.2021.05.001

消化道出血是一种具有突发性的急症，具有较高的死亡率，为急诊科中常见的急症，患者若得不到及时有效治疗，会严重威胁患者的生命安全[1]。消化道出血的常见病因包括胃癌、急性胃黏膜损伤、胃底食管静脉曲张破裂、溃疡病等[2]。生长抑素能够有效解决消化道出血症状，降低患者血压，快速减少内脏部位的血流，是一种用于治疗消化道出血的常用药[3]。此外，奥美拉唑也是治疗消化道出血的常用药物，可有效止血、促进血小板聚集、抑制胃酸分泌[4]。本次研究将生长抑素与奥美拉唑……