Successful Case of Somatostatin Analog Stopping Gastrointestinal Bleeding, One of the Most Frequent Complications After Simultaneous Pancreas-kidney Transplantation: A Case Report

Thrombin combined with somatostatin for treatment of patients with upper gastrointestinal hemorrhage: Impact on inflammatory factors and coagulation function

AIM

To evaluate the effect of thrombin combined with somatostatin on inflammatory factors and coagulation function in patients with upper gastrointestinal hemorrhage.

METHODS

Seventy patients with upper gastrointestinal bleeding treated from July 2015 to June 2017 were divided into either an observation group or a control group. The control group was given octreotide alone, and the observation group was given thrombin combined with octreotide. After treatment, serum inflammatory factors, coagulation function, clinical efficacy, and adverse reactions were compared between the two groups.

RESULTS

Time to hemostasis was significantly shorter in the observation group than in the control group (16.75 h ± 3.12 h vs 25.46 h ± 3.45 h, t = 11.078, P < 0.01). The effective rate was significantly higher in the observation group than in the control group [94.29% (33/35) vs 77.14% (27/35), χ² = 4.200, P < 0.05]. Serum tumor necrosis factor α (5.32 ng/L ± 0.75 ng/L vs 8.02 ng/L ± 1.24 ng/L, t = 11.022, P < 0.01 ) and interleukin (IL)-6 levels (20.12 ng/L ± 3.45 ng/L vs 31.26 ng/L ± 4.12 ng/L, t = 12.264, P < 0.01) were significantly lower and serum IL-2 (6.75 ng/L ± 1.02 ng/L vs 4.68 ng/L ± 0.76 ng/L, t = 10.349, P < 0.01) was significantly higher in the observation group than in the control group. Prothrombin time (13.32 s ± 2.2 s vs 16.84 s ± 3.24 s, t = 5.249, P < 0.05) and activated partial thromboplastin time (33.12 s ± 4.56 s vs 40.18 s ± 5.35 s, t = 5.942, P < 0.05) were significantly lower, and platelets (67.82 × 10⁹/L ± 8.36 × 10⁹/L vs 58.75 × 10⁹/L ± 6.82 × 10⁹/L, t = 4.973, P < 0.05) and plasma fibrinogen (315.45 g/L ± 45.24 g/L vs 284.72 g/L ± 40.15 g/L, t = 3.006, P < 0.05) were significantly higher in the observation group than in the control group.

CONCLUSION

Thrombin combined with somatostatin can shorten hemostatic time and improve clinical efficacy in patients with upper gastrointestinal hemorrhage, which may be related to reducing inflammatory symptoms and improving coagulation function.