Brief analysis of the clinical treatment effect of non-varicose upper gastrointestinal
bleeding
Gastrointestinal bleeding is a common disease in clinical practice, which is divided into
upper gastrointestinal bleeding and lower gastrointestinal bleeding. The bleeding point of
patients with upper gastrointestinal bleeding is the entire gastrointestinal tract above the
Treitz ligament, mainly gastric, duodenal ulcers and esophageal bleeding. The symptoms
of upper gastrointestinal bleeding are relatively common in clinical practice, accounting
for about 30% of gastrointestinal bleeding. Non-varicose upper gastrointestinal bleeding
is a bleeding symptom caused by non-varicose veins in the gastrointestinal tract above
the Treitz ligament. The factors that cause the symptoms of non-varicose upper
gastrointestinal bleeding are ulcers and erosion of the private membrane, varicose vein
rupture, vascular diseases, etc. If the patient develops the disease, the bleeding will not
stop, causing acute peripheral circulatory failure. Therefore, due to hypoxia and
accumulation of metabolic products, the capillaries are damaged, which has an extremely
adverse effect on the blood supply of organs such as the heart and brain, thereby
causing shock and death. Studies have found that 50 to 150 cases of non-varicose upper
gastrointestinal bleeding symptoms appear in every 100,000 people, and the mortality
rate reaches 10%. This article selected 184 patients with non-varicose upper
gastrointestinal bleeding, analyzed the treatment methods and effects, and now reports
as follows.
1 Data and methods
1. 1 General data 184 patients with non-varicose upper gastrointestinal bleeding admitted
to our hospital from March 2015 to February 2018 were selected and divided into a study
group and a control group according to digital extraction, with 92 cases in each group. All
patients met the diagnostic criteria for non-varicose upper gastrointestinal bleeding, had
no blood in the stool or vomiting blood at admission, and had not received H2 receptor
antagonists and proton pump inhibitors in the past 2 weeks. Among them, there were 98
males and 86 females, aged 20 to 75 years old, with an average age of (41.6±3.6) years
old. There was no statistically significant difference in general data such as age, gender,
and symptoms between the two groups of patients (P>0.05), which was comparable.
1.2 Methods Both groups of patients received conventional treatment measures, mainly
including oxygen inhalation, fluid replacement, blood pressure balance, elimination of
oxygen-consuming free radicals, infection prevention, water and electrolyte balance,
symptomatic treatment, etc. The research group was given pantoprazole on the basis of
conventional treatment. 40 mg pantoprazole was placed in 100 ml 0.9% sodium chloride
injection and mixed, intravenous drip, once/d, for 4 days. The control group was given
famotidine 20 mg on the basis of conventional treatment, intravenous drip, twice/d, for 4
days.
1.3 Criteria for determining efficacy [1] Cured: clinical symptoms of hematemesis and
melena are eliminated, and fecal occult blood test is performed 3 times within 7 days (-);
markedly effective: clinical symptoms of hematemesis and melena are eliminated, and
fecal occult blood test is performed 3 times within 7 days (+~++); improved: clinical
symptoms of hematemesis and melena are stopped, and fecal occult blood test changes
from positive to positive (+~+++); ineffective: clinical symptoms of hematemesis or
melena are not completely eliminated or relieved after 7 days of treatment. Total effective
rate = cure rate + markedly effective rate + improvement rate.
1.4 Statistical methods All data were analyzed using SPSS17.0 software. Quantitative
data were expressed as mean ± standard deviation (), and t test was used; enumeration
data were expressed as rate (%), and χ2 test was used. P<0.05 indicated that the
difference was statistically significant.
2 Results
After treatment, the total effective rate of the study group was significantly higher than
that of the control group, and the difference was statistically significant (P<0.05); the
average hemostasis time of the study group was (30.5±2.6) h, and that of the control
group was (53.6±8.4) h, and the difference between the two groups was statistically
significant (P<0.05). No adverse reactions such as nausea and vomiting occurred in
either group.
3 Discussion
Upper gastrointestinal bleeding diseases have a very high incidence rate. About 85% of
patients with peptic ulcers have bleeding due to some inducements. In order to detect
and prevent the disease early, timely medical examination is required when ulcers or
gastric bleeding occur. Traditional X-ray barium meal examinations and endoscopic
examinations are widely used in clinical practice. Patients with non-varicose upper
gastrointestinal bleeding often experience cell hypoxia symptoms or even death if the
bleeding is not stopped in time [2]. Patients often develop from dizziness and nausea in
the early stage to fatigue, weakness, shock and death. In particular, the elderly are often
accompanied by a large number of diseases. If emergency treatment is not given, even if
the patient does not bleed heavily, it will lead to organ failure and death. Therefore, early
detection and reasonable treatment are important for patients.
The control group patients used famotidine. According to research and analysis, it is an
H2-receptor antagonist. Among them, pentagastrin will have a certain effect on gastric
acid secretion, but it cannot be reasonably controlled. In particular, it cannot avoid the
effect of gastrin on gastric acid formation after eating during the day. Therefore, the acid
suppression effect has certain limitations and the effect is not ideal. Pantoprazole is a
gastric parietal cell proton pump inhibitor. It has a certain stability in neutral and weakly
acidic environments, and is rapidly activated in strongly acidic environments. Its pH-
dependent activation characteristics make it more selective for H+/K+-ATPase [3]. This
drug can specifically block the H+/K+-ATPase on the secretory microtubules and tubular
vesicles in the cytoplasm of parietal cells, making this enzyme irreversibly inhibited,
thereby effectively preventing large amounts of gastric acid secretion. Because H+/K+-
ATPase is the last link in the acid secretion process of parietal cells, this drug has a
relatively strong acid-suppressing effect. It can non-competitively inhibit gastric acid
secretion caused by gastrin, histamine, and choline, and can also inhibit some basal
gastric acid secretion that is not affected by choline or H2 receptor blockers. Its main
clinical features are: significant acid suppression effect, persistence and
progressiveness, reaching a stable state after 3 to 5 days, maintaining a relatively high
intragastric pH, and no obvious tolerance for continuous medication [4]. Studies have
shown that pantoprazole is effective in the clinical treatment of non-varicose upper
gastrointestinal bleeding and has a high clinical value.
