摘要
目的探讨胃镜介入治疗后联合常规三联疗法治疗消化性溃疡合并上消化道出血的有效性及安全性。方法 70例消化性溃疡出血患者随机分为治疗组和对照组。两组基础治疗相同,并采用静脉注射埃索美拉唑20mg+羟氨苄青霉素1.0g+替硝唑0.5g治疗,治疗组在对照组治疗的基础上,采用内镜注射针注射去甲肾上腺素治疗。测定治疗前及治疗后12、48、72h空腹胃液pH值,评价临床疗效,记录不良反应。结果治疗组临床疗效总有效率为97.1%,明显优于对照组(74.3%),相比较差异有统计学意义(P<0.05)。治疗后12、48、72h两组患者pH值均逐渐升高,与治疗前比较差异有统计学意义(P<0.05);且治疗组pH值升高幅度显著优于对照组(P<0.05)。治疗组再出血发生率和不良反应发生率显著低于对照组(P<0.05)。结论胃镜介入治疗后联合应用埃索美拉唑三联疗法治疗消化性溃疡并上消化道出血临床疗效好,且安全可靠,值得临床推广应用。
Objective To evaluate the efficacy and safety of endoscopic interventional therapy combined with conventional triple therapy in patients with peptic ulcer complicated with upper gastrointestinal bleeding（UGB）.Methods Seventy peptic ulcer patients complicated with UGB were randomly divided into treatment group and control group.Both groups were received routine medical care and esomeprazole 20 mg ＋ amoxycillin 1.0 g ＋ tinidazole 0.5 g by intravenous injection.On the basis of treatment of control group,treatment group was received an endoscopically administrated injection of noradrenaline solution.The changes of pH of the empty stomach gastric juice were monitored before the treatment and 12,48,and 72 hours after the treatment.The clinical efficacy was evaluated and the adverse reactions were recorded.Results The total effective rate of treatment group was 97.1%,which was significantly superior to that of control group（74.3%）,and the difference was statistically significant（P〈0.05）.12,48,and 72 hours after the treatment,the pH values of the two groups were gradually elevated,there were statistically significant differences between before and after the treatment（P〈0.05）.The pH value of treatment group was significantly higher than that of control group（P〈0.05）.The re-bleeding rate and the incidence of adverse reactions of treatment group were significantly lower than those of control group（P〈0.05）.Conclusions Endoscopic interventional therapy combined with conventional triple therapy in patients with peptic ulcer complicated with UGB is effective and safe,and it is worthy to be popularized.
出处
《实用预防医学》
CAS
2010年第8期1614-1616,共3页
Practical Preventive Medicine
关键词
胃镜介入治疗
埃索美拉唑
三联疗法
消化性溃疡
上消化道出血
Endoscopic interventional Therapy
Esomeprazole
Triple therapy
Peptic ulcer
Upper gastrointestinal bleeding
