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目的:观察生长抑素类似物奥曲肽(善宁)对老年人消化性溃疡并上消化道大出血的疗效。方法:回顾性分析57例住院病人的临床资料,分为常规治疗组和善宁组,常规治疗组主要药物为质子泵抑制剂(PPI)40mg加入液体静脉滴注,Q12h-Q6h;善宁组在PPI基础上加用善宁0.2mg+生理盐水38mL持续静脉泵入,50μg/h,Q6h。结果:常规治疗组从开始治疗到活动性出血停止的中位时间是7.5h(3.0h~36.0h),善宁组的中位时间是4.0h(2.0~19.0h,P<0.01);常规治疗组和善宁组分别有7例(17.4%)、2例(9.5%)接受急诊内镜检查和内镜下治疗,差异有统计学意义(P<0.05);外科手术治疗常规治疗组3例(8.3%)、善宁组1例(4.8%),差异有统计学意义(P<0.05)。常规治疗组中位输血(洗涤红细胞)量是8U(4~16U),善宁组为6U(2~12U),差异有统计学意义(P<0.05)。常规治疗组的平均住院时间(18.2±6.7)天,善宁组为(13.7±5.3)天,差异有统计学意义(P<0.05)。结论:生长抑素类似物奥曲肽(善宁)对老年人消化性溃疡合并急性上消化道大出血病人的治疗有良好的效果。
Objective: To observe the efficacy of the somatostatin analogue octreotide (Shanning) on peptic ulcer and upper gastrointestinal hemorrhage in the elderly. Methods: The clinical data of 57 inpatients were retrospectively analyzed and divided into two groups: the conventional treatment group and the Shanning group. The main drugs in routine treatment group were intravenous infusion of 40mg PPI and Q12h-Q6h, On the basis of PPI, Shanning 0.2mg + normal saline 38mL was used for continuous intravenous infusion, 50μg / h, Q6h. Results: The median time from the start of treatment to active cessation of bleeding was 7.5h (3.0h ~ 36.0h) in the conventional treatment group and 4.0h (2.0 ~ 19.0h, P <0.01) There were 7 cases (17.4%) and 2 cases (9.5%) in the treatment group and the Shanning group respectively. The difference was statistically significant (P <0.05). There were 3 cases in the conventional surgery group (8.3%), Shanning group 1 case (4.8%), the difference was statistically significant (P <0.05). In the conventional treatment group, the median amount of blood transfusion (washed red blood cells) was 8U (4 ~ 16U), while that of ShanNing group was 6U (2 ~ 12U), the difference was statistically significant (P <0.05). The average length of hospital stay was (18.2 ± 6.7) days in the conventional treatment group and (13.7 ± 5.3) days in the Shan Ning group, with a significant difference (P <0.05). Conclusion: The somatostatin analogue octreotide (Shanning) has a good effect on the treatment of elderly patients with peptic ulcer complicated by acute upper gastrointestinal bleeding.