To observe the efficacy and safety of snake venom hemocoagulase injection combined with tranexamic acid injection and omeprazole sodium injection in the treatment of emergency patients with acute upper gastrointestinal bleeding.

Patients with acute upper gastrointestinal bleeding were divided into control group and treatment group according to the cohort method. Patients in the control group were administered with tranexamic acid injection 500 mg (iv; qd) combined with omeprazole sodium for injection 40 mg (bid); the treatment group was given snake venom hemocoagulase injection 0.5-1.5 kU (once in the morning and once in the evening) on the basis of the control group. All patients were treated for 3 d. The total effective rate, coagulation function [platelet (PLT), activated partial thromboplastin time (APTT), fibrinogen (Fib), plasma prothrombin time (PT)], hemodynamics [plasma viscosity (PV), erythrocyte sedimentation rate (ESR), whole blood high shear viscosity (WBVH) and hematocrit (HCT)], inflammatory stress response [C-reactive protein (CRP), cortisol (Cor) and neutrophil to lymphocyte ratio (NLR)], and adverse drug reactions were compared between two groups.

A total of 120 patients were enrolled in this trial, including 58 in the control group and 62 in the treatment group. After treatment, the effective rates of the control group and the treatment group were 79.31% (46 cases/58 cases) and 95.16% (59 cases / 62 cases), respectively, with statistical difference (P<0.05). After treatment, the PLT levels in the control and treatment groups were (170.18±10.86) and (180.18±9.83)×10⁹·L^-1, respectively; APTT values were (47.39±4.52) and (44.68±4.62), respectively; Fib levels were (2.98±0.33) and (3.21±0.28) g·L^-1, respectively; PT values were (19.21±3.76) and (17.01±2.62) seconds, respectively; PV levels were (1.98±0.36) and (2.38±0.43) MPa·s, respectively; ESR values were (53.69±4.52)% and (59.89±14.62)%, respectively; WBVH levels were (7.08±0.23) and (7.98±0.28) MPa·s, respectively; HCT levels were (49.21±5.62) and (52.01±8.62) L·L^-1, respectively; CRP levels were (8.63±1.36) and (6.38±0.93) mg·L^-1, respectively; Cor values were (323.69±14.82) and (315.86±14.62) mmol·L^-1, respectively; NLP levels were 4.08±0.43 and 2.98±0.48. All these differences were statistically significant (P<0.05). During the trial, the adverse drug reactions in the control group were mainly stomach distension, dizziness, headache and diarrhea, and the adverse drug reactions in the treatment group were mainly stomach distension, dizziness, headache and diarrhea. The total incidences of adverse drug reactions in the control group and the treatment group were 10.34% (6 cases / 58 cases) and 12.90% (8 cases / 62 cases), respectively, with no statistically significant difference (P>0.05).

Snake venom hemocoagulase injection combined with tranexamic acid injection and omeprazole sodium for injection has significant curative effect on emergency patients with acute upper gastrointestinal bleeding, with low adverse drug reactions.