强化抑酸方案对行内镜止血术的老年ANVUGIB患者手术相关临床指标、再出血率及实验室指标的影响

Influence of intensified acid suppression scheme on operation-related clinical parameters, re-bleeding rate and laboratory indexes of elderly patients with ANVUGIB underwent endoscopic hemostasis

摘要:

摘要：目的  探讨强化抑酸方案对行内镜止血术的老年急性非静脉曲张性上消化道大出血（ANVUGIB）患者手术相关临床指标、再出血率及实验室指标的影响。方法 研究对象选取该院2015年6月-2017年6月收治的行内镜止血术老年ANVUGIB患者共150例，以随机数字表法分为对照组（75例）和观察组（75例），分别给予常规剂量和强化剂量泮托拉唑辅助治疗，比较两组患者临床疗效、呕血和黑便消失时间、止血时间、总输血量、住院时间、再出血率、中转开腹率、治疗后24和72 h实验室指标水平及不良反应发生率。结果 观察组患者治疗总有效率明显高于对照组（P <0.05）；观察组患者呕血和黑便消失时间、止血时间、总输血量及住院时间均明显优于对照组（P <0.05）；观察组患者再出血率和中转手术率均明显低于对照组（P <0.05）；观察组患者治疗后24和72 h实验室指标水平均明显优于对照组（P <0.05）；两组患者不良反应发生率比较差异无统计学意义（P >0.05）。结论 强化抑酸方案用于行内镜止血术老年ANVUGIB患者可有效实现早期止血，缓解症状体征，减少围手术期失血量，降低中转开腹风险，并有助于改善红细胞压积（PCV）和尿素氮（BUN）水平。

Abstract:

Abstract: Objective To investigate the influence of intensified acid suppression scheme on operation-related clinical parameters, re-bleeding rate and laboratory indexes of elderly patients with ANVUGIB underwent endoscopic hemostasis. Methods 150 elderly patients with ANVUGIB underwent endoscopic hemostasis were chosen from June 2015 to June 2017 and randomly divided into control group (75 patients) with conventional dose of pantoprazole and observation group (75 patients) with intensified dose of pantoprazole; and the clinical efficacy, the disappeared time of spitting blood and melena, hemostasis time, total blood transfusion volume, hospitalization time, re-bleeding rate, conversion to open surgery rate, the levels of laboratory index in 24 h and 72 h after treatment and adverse reaction incidence of both groups were compared. Results The clinical total effects of observation group were significantly higher than that in control group (P < 0.05). The disappeared time of spitting blood and melena, hemostasis time, total blood transfusion volume, hospitalization time of observation group were significantly better than that in control group (P < 0.05). The re-bleeding rate and conversion to open surgery rate of observation group were significantly lower than that in control group (P < 0.05). The levels of laboratory index in 24 h and 72 h after treatment of observation group were significantly better than that in control group (P < 0.05). There was no significant difference in the adverse reaction incidence between the two groups (P > 0.05). Conclusion Intensified acid suppression scheme in the treatment of elderly patients with ANVUGIB undergoing endoscopic hemostasis can efficiently achieve hemostasis in early stage, relieve symptoms and signs, decrease the blood loss amount in perioperative period, reduce the conversion to open operation risk and be helpful to improve the levels of PCV and BUN.