目的 探討氨基己酸聯(lián)合雷尼替丁治療上消化道出血的臨床療效。方法 選取2019年9月-2021年9月商丘市立醫(yī)院收治的106例上消化道出血患者,按照隨機數(shù)字表法分為對照組和治療組,每組各53例。對照組靜脈滴注鹽酸雷尼替丁注射液,50 mg加入0.9%氯化鈉注射液250mL中稀釋后緩慢靜滴,1次/d。治療組在對照組治療基礎(chǔ)上靜脈滴注氨基己酸注射液,4 g加入5%葡萄糖注射液100 mL中稀釋靜滴,1次/d。兩組患者連續(xù)治療7d。觀察兩組的臨床療效,比較兩組臨床癥狀好轉(zhuǎn)時間、凝血指標(biāo)和血清學(xué)指標(biāo)。結(jié)果 治療后,治療組總有效率是98.11%,顯著高于對照組的81.13%(P<0.05)。治療后,治療組患者出現(xiàn)嘔血、黑便、貧血、發(fā)熱等癥狀好轉(zhuǎn)時間均顯著短于對照組(P<0.05)。治療后,兩組血小板(PLT)、纖維蛋白原(FIB)指標(biāo)均較治療前顯著升高,而凝血酶原時間(PT)、活化部分凝血活酶時間(APTT)顯著縮短(P<0.05);治療后,治療組凝血指標(biāo)改善優(yōu)于對照組(P<0.05)。治療后,兩組血清炎癥因子白細(xì)胞介素1β(IL-1β)、白細(xì)胞介素6(IL-6)、皮質(zhì)醇(Cor)、腫瘤壞死因子-α(TNF-α)均較治療前顯著降低(P<0.05);治療后,治療組血清因子水平顯著低于對照組(P<0.05)。結(jié)論 氨基己酸聯(lián)合雷尼替丁治療上消化道出血具有較好的臨床療效,止血效果顯著,可改善凝血及炎癥反應(yīng),值得臨床推廣與使用。

Objective To explore the clinical study of aminocaproic acid combined with ranitidine in treatment of upper gastrointestinal hemorrhage. Methods A total of 106 patients with upper gastrointestinal bleeding admitted to Shangqiu Municipal Hospital from September 2019 to September 2021 were selected and divided into control group and treatment group according to random number table method, with 53 cases in each group. Patients in the control group were iv administered with Ranitidine Hydrochloride Injection, 50 mg was diluted into 250 mL 0.9% sodium chloride injection and then dropped slowly, once daily. Patients in the treatment group were iv administered with Aminocaproic Acid Injection, 4 g was diluted into 5% glucose injection 100 mL for intravenous drip, once daily. Both groups were treated for 7 d. The clinical efficacy of the two groups were observed, and the improvement time of clinical symptoms, coagulation indexes and serological indexes were compared between the two groups. Results After treatment, the total effective rate in the treatment group was 98.11%, significantly higher than that in the control group (81.13%, P < 0.05). After treatment, the improvement time of hematemesis, melena, anemia, fever and other symptoms in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, platelet (PLT) and fibrinogen (FIB) indexes in two groups were significantly increased compared with before treatment, while prothrombin time (PT) and activated partial thrombin time (APTT) were significantly decreased (P < 0.05). After treatment, the coagulation index of the treatment group was better than that of the control group (P < 0.05). After treatment, serum interleukin-1 β (IL-1β), interleukin-6 (IL-6), cortisol (Cor) and tumor necrosis factor -α (TNF-α) in two groups were significantly decreased compared with before treatment (P < 0.05). After treatment, the level of serum factor in treatment group was significantly lower than that in control group (P < 0.05). Conclusion Aminocaproic acid combined with ranitidine has good clinical effect in treatment of upper gastrointestinal hemorrhage with remarkable hemostatic effect, and can improve coagulation and inflammatory reaction, which is worthy of clinical promotion and use.

R975