质子泵抑制剂治疗内镜黏膜下剥离术后人造溃疡的效果比较  

Effect comparison of proton pump inhibitor in the treatment of endoscopic submucosal dissection induced artificial ulcers

作　　者：戴胜兰[1] 王涛[1] 姚俊[1] 许亚平[1] 

机构地区：[1]江苏大学附属人民医院消化内科,江苏镇江212002

出　　处：《中国医药导报》2015年第33期155-158,共4页China Medical Herald

摘　　要：目的 比较质子泵抑制剂奥美拉唑疗程4周或8周治疗内镜黏膜下剥离术（ESD）后人造溃疡的效果。方法 回顾性分析了江苏大学附属人民医院2012年2月~2014年5月的91例诊断为胃腺瘤、间质瘤、早期胃癌及癌前病变的患者ESD术后人造溃疡患者的临床资料,所有患者ESD术后前3 d均接受注射用奥美拉唑治疗,后为口服奥美拉唑40 mg/d,所有患者均于术后4周及8周随访并进行胃镜检查。根据奥美拉唑的疗程将其分为4周组（45例）及8周组（46例）。比较两组迟发性出血的发生率及溃疡的愈合情况。结果 两组ESD术后迟发性出血率及术后4周和8周复查溃疡愈合情况比较,差异均无统计学意义（P〉0.05）。结论 对于ESD术引起的人造溃疡,奥美拉唑治疗4周与治疗8周的效果相同,考虑到成本效益,奥美拉唑疗程4周愈合ESD引起的人造溃疡是可行的。Objective To compare the efficacy Of 4 and 8 weeks of Omeprazole treatment for artificial gastric ulcers af- ter endoscopic submucosal dissection （ESD）. Methods Clinical data of 91 patients with artificial ulcers who underwent ESD for gastric adenoma, interstitial tumor or early gastric cancer from February 2012 to May 2014 in People＇s Hospital Affiliated to Jiangsu University were retrospectively analyzed. All patients received Omeprazole intravenously for 3 days after ESD, and then orally （40 mg/d） for 4 weeks or 8 weeks. Follow-up endoscopy was performed at 4 weeks and 8 weeks after ESD. Patients were divided into d-week group （45 cases） and 8-week group （46 cases） according to the treatment course of Omeprazole. The rates of delayed bleeding and healing of ulcer in two groups were compared. Re- suits There were no statistically significant differences in the delayed bleeding rate and ulcer healing rate between the two groups （P 〉 0.05）. Conclusion For ESD-induced gastric ulcers, 4 weeks treatment of Omeprazole has the same ef- fect with 8 weeks. Considering cost-effectiveness, proton pump inhibitor therapy for 4 weeks may be sufficient for ESD-induced artificial ulcers.

关 键 词：内镜黏膜下剥离术 溃疡 人造 质子泵抑制剂 内镜下黏膜切除术 

分 类 号：R656.6[医药卫生—外科学]