目的 探討注射用尖吻蝮蛇血凝酶聯(lián)合生長(zhǎng)抑素和埃索美拉唑治療上消化道出血的臨床療效。方法 選取駐馬店市中心醫(yī)院2014年1月-2016年8月收治的上消化道出血患者80例，隨機(jī)分為對(duì)照組和治療組，每組各40例。對(duì)照組患者靜脈泵注注射用生長(zhǎng)抑素，3 mg加入生理鹽水500 mL中，泵入速度40 mL/h，2次/d；同時(shí)靜脈滴注注射用埃索美拉唑鈉，40 mg加入生理鹽水100 mL中，30 min內(nèi)滴完，2次/d。治療組患者在對(duì)照組的基礎(chǔ)上靜脈推注注射用尖吻蝮蛇血凝酶，1 U溶于20 mL生理鹽水中，1次/d。兩組均連續(xù)治療5 d。比較兩組患者治療前后臨床療效、輸血量、止血時(shí)間、血紅蛋白（Hb）水平、凝血指標(biāo)及再出血率。結(jié)果 治療后，對(duì)照組的總有效率為80.00%，顯著低于治療組的95.00%，兩組總有效率比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，治療組患者輸血量與止血時(shí)間均少于對(duì)照組，兩組比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。治療后，兩組Hb水平均顯著升高（P<0.05）；且治療組的Hb水平高于對(duì)照組（P<0.05）。治療后，兩組PT、APTT均顯著縮短，同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義（P<0.05）；且治療后治療組PT、APTT均短于對(duì)照組，兩組比較差異具有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 注射用尖吻蝮蛇血凝酶聯(lián)合生長(zhǎng)抑素和埃索美拉唑治療上消化道出血可有效縮短止血時(shí)間、減少輸血量，且利于血紅蛋白水平的恢復(fù)，具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To investigate the clinical effect of Agkistrodon haemocoagulase combined with somatostatin and esomeprazole in treatment of upper gastrointestinal bleeding. Methods Patients (80 cases) with upper gastrointestinal bleeding in Zhumadian Central Hospital from January 2014 to August 2016 were randomly divided into control and treatment groups, and each group had 40 cases. Patients in the control group were administered with Somatostatin for injection by iv pump infusion, 3 mg added into 500 mL normal saline, and the speed was 40 mL/h, twice daily. the patients were iv administered with Esomeprazole Sodium for injection, 40 mg added into 100 mL normal saline, and the infusion time was less than 30 min, twice daily. Patients in the treatment group were iv administered with Haemocoagulase Agkistrodon for injection on the basis of control group, 1 U added into 20 mL normal saline, once daily. Patients in two groups were treated for 5 d. After treatment, the clinical efficacy, blood transfusion amount, hemostatic time, coagulation indexes, and rebleeding rate in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control group was 80.00%, which was significantly lower than 95.00% in the treatment group, and there was difference between two groups (P<0.05). After treatment, blood transfusion amount and hemostatic time in treatment group were significantly shorter than those in the control group, with significant difference between two groups (P<0.05). After treatment, Hb levels in two groups were significantly increased (P<0.05). And Hb level in the treatment group was significantly higher than that in the control group (P<0.05). After treatment, PT and APTT in two groups were significantly shortened, and the difference was statistically significant in the same group (P<0.05). The PT and APTT in the treatment group were significantly shorter than those in the control group, with significant difference between two groups (P<0.05). Conclusion Agkistrodon haemocoagulase combined with somatostatin and esomeprazole in treatment of upper gastrointestinal bleeding can effectively shorten the hemostatic time and reduce the blood transfusion amount, and is conducive to Hb level recovery, which has a certain clinical application value.