质子泵抑制剂在消化性溃疡并发症治疗中的作用  

The Role of Proton-pump Inhibitors for the Treatment of the Complications of Peptic Ulcers

作　　者：魏刚[1] 全卓勇[1] 彭开勤[1] 张应天[1] 

机构地区：[1]江汉大学附属医院普外科,武汉430016

出　　处：《临床消化病杂志》2007年第2期107-109,112,共4页Chinese Journal of Clinical Gastroenterology

摘　　要：目的 探讨质子泵抑制剂（PPIs）在消化性溃疡并发症出血、穿孔和幽门梗阻治疗中的作用。方法 对我科2002年8月-2005年8月的消化性溃疡并发出血、穿孔和幽门梗阻的住院病例行回顾性分析，以前1年半病例为对照组，后1年半病例为试验组。结果 内镜止血成功后采用PPIs的新用法：试验组3d内、30d内再出血率分别为3．22％、6．45％，3d内平均输血量2．38±2．12u，与对照组比较均有显著性差异（P（0．05）。空腹穿孔或穿孔在6h以内者采用PPIs的新用法，试验组3周内穿孔非手术治疗治愈率、中转手术率分别为91．67％、4．17％，与对照组比较均有显著性差异（P（0．05）。幽门良性梗阻者采用PPIs新用法和内镜球囊扩张，成功率达72．73％。结论 PPIs新用法对巩固消化性溃疡并发症出血、穿孔和幽门梗阻非手术治疗的疗效起到了举足轻重的作用。Objective To study the role of proton-pump inhibitors（PPIs） for the treatment of the complications of peptic ulcer： bleeding, perforation, pyloric obstruction. Methods The patients with bleeding, perforation, pyloric obstruction from peptic ulcers during August 2002 - August 2005 were retrospectively analysed, the cases of first one and half a year for control group and the ones of later one for trial group. Results Rebleeding rate in 3 d,30 d and average blood-transfusion volume in 3 d of trial group was 3.22% ,6. 45% ,2.38 ±2. 12 u respectively with the new administration of PPIs after successful endoscopic treatment of peptic ulcer bleeding. There were significant differences respectively compared to control group（ P 〈0. 05 ）. For the patients, perforated with empty stomach or within 6 h and treated with the new administration of PPIs, the cure rate with non-operative treatment of perforation and operation convertion rate in 3 weeks of trial group were 91.67% ,4. 17% respectively. There were significant differences respectively compared to control group（ P 〈0. 05 ）. The successful rate was accessible to 72. 73% ,for the patients with benign pyloric obstruction treated with endoscopic balloon dilation and the new administration of PPIs. Condusion The new administration of PPIs play an indispensable role in consolidating non-operative therapy effect in bleeding, perforation, pyloric obstruction of peptic ulcer complications.

关 键 词：消化性溃疡并发症 幽门螺杆菌(Hp) 质子泵抑制剂(PPIs) 非甾体抗炎药(NSAIDs) 

分 类 号：R573.1[医药卫生—消化系统]