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目的：探讨奥曲肽联合栓塞介入治疗消化性溃疡引发的上消化道出血的临床研究。方法：将30 例消化道溃疡合并急性消化道大出血患者随机分为对照组和联合治疗组，每组15 例，对照组患者采用栓塞介入治疗，联合治疗组采用奥曲肽联合栓塞治疗，在48 h后评价短期疗效，并随访1 月观察患者的出血复发情况及不良反应；采用联合免疫试剂盒检测患者在治疗前及治疗后2 天，3 天和7 天的大便隐血，并记录患者隐血转阴时间和住院时间。结果：联合治疗组患者的短期有效率为92.9 %明显高于对照组的60.0 %，且差异有统计学意义（X2=8.96，P＜0.05）；治疗前，两组患者的大便隐血试验均为阳性，治疗2 天后，联合治疗组和对照组的隐血阳性率分别为21.4 %和66.7 %，两组比较差异有显著意义（X2=6.66，P＜0.01）；治疗3 天后，联合治疗组92.8 %患者隐血试验转阴，显著高于对照组60.0 %，且差异有统计学意义（X2=4.66，P＜0.05）；对照组患者的隐血转阴时间和住院时间分别为（4.15± 2.37）天和（7.22± 1.98）天高于联合治疗组，其隐血转阴时间和住院时间分别为（2.77± 1.98）天和（5.33± 2.07）天，两组相比，差异有统计学意义（P＜0.05）。结论：奥曲肽联合栓塞介入治疗可以快速止血，再出血发生率低和安全等特点，能有效治疗消化性溃疡引发的急性上消化道大出血。

英文摘要:

Objective:To investigate the clinical study of interventional therapy combined with octreotide for elderly patients with peptic ulcer induced acute upper gastrointestinal bleeding.Methods:30 cases of peptic ulcer induced acute upper gastrointestinal bleeding patients were randomly divided into control group and combined treatment group, 15 cases in each group, control group were treated with embolization interventional therapy, combined treatment group with octreotide combined with embolization therapy, we evaluated short-term curative effect after 48 h, and visited in 1 month to observe patients bleeding recurrence and adverse reaction. Combined immunoassay kit detected fecal occult blood before treatment and after treatment 2 days, 3 days and 7 days and record occult blood clearance time and hospitalization time.Results:The patients in the treatment group the short-term effective rate was 92.9% significantly higher than 60%in the control group, and the difference was statistically significant (X2=8.30, P < 0.05); Fecal occult blood test before treatment, two groups of patients were positive, 2 days after treatment, the positive rate of occult blood in the combined treatment group and control group were 21.4%and 66.7%, respectively, there was significant difference between two groups (X2=6.66, P < 0.01); 3 days after treatment, combined treatment group of 92.8%patients with occult blood test negative, significantly higher than 60% in the control group, and the difference was statistically significant (X2=4.66, P <0.05); The control group of patients with occult blood clearance time and hospitalization time were (4.15± 2.37) days and (7.22± 1.98) days, respectively, but in the treatment group, which were (2.77 ± 1.98) days and (5.33 ± 2.07) days, respectively, the difference was statistically significant (P < 0.05).Conclusion:Qctreotide combined with interventional therapy can quickly stop bleeding, rebleeding rate is low and security features, which can effective treatment of peptic ulcer with acute upper gastrointestinal bleeding.

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