双抗血小板致消化道溃疡性出血患者的HP根治方案选择及安全性比较  

Scheme selection and safety comparison of Helicobacter pylori eradication therapies of patients with hemorrhagic peptic ulcer bleeding induced by dual antiplatelet therapy

作　　者：王菲 徐光旭 唐勇 刘静 

机构地区：[1]重庆市永川区人民医院消化内科,重庆永川402160

出　　处：《海南医学》2017年第21期3451-3453,共3页Hainan Medical Journal

基　　金：重庆市卫生计生委医学科研项目(编号:2011-2-427)

摘　　要：目的研究双抗血小板致消化道溃疡性出血患者的HP根治方案选择并对比其安全性。方法选取2015年5月至2016年8月重庆市永川区人民医院消化内科收治的双重抗血小板所致消化道溃疡性出血患者82例。根据随机数表法分为观察组和对照组各41例。对照组患者予以阿莫西林联合奥美拉唑治疗,观察组患者予以阿莫西林联合泮托拉唑治疗,两组均治疗1周。比较两组患者的临床疗效、出血量、止血时间、住院时间,以及治疗前后血常规指标的变化和不良反应发生情况。结果观察组患者的治疗总有效率为92.68%,明显高于对照组的75.61%,差异有统计学意义(P<0.05);观察组患者的出血量、止血时间、住院时间分别为(412.3±83.2)m L、(7.1±2.0)h、(9.7±2.5)d,均低于对照组的(522.8±93.7)m L、(9.5±3.0)h、(13.1±3.2)d,差异均具有统计学意义(P<0.05);治疗后,观察组患者的红细胞(RBC)、血红蛋白(Hb)水平分别为(4.7±0.8)×109/L、(112.4±15.3)g/L,均明显高于对照组的(3.7±0.7)×109/L、(99.2±13.6)g/L,差异均具有统计学意义(P<0.05);而两组患者的恶心呕吐、心悸、眩晕发生率比较差异无统计学意义(P>0.05)。结论阿莫西林联合泮托拉唑治疗双抗血小板致消化道溃疡性出血的效果显著,有利于患者早日康复,改善血常规,安全性好。Objective To study scheme selection and safety comparison of Helicobacter pylori eradication（HPE）therapies of patients with hemorrhagic peptic ulcer bleeding induced by dual antiplatelet therapy. Methods From May2015 to August 2016, 82 patients with hemorrhagic peptic ulcer bleeding induced by dual antiplatelet therapy were selected and divided into the observation group and the control group according to random number table method, with 41 cases in each group. The control group was given amoxicillin combined with omeprazole treatment, and the observation group was given amoxicillin combined with pantoprazde. The two groups were treated for 1 week. The clinical efficacy,bleeding volume, hemostasis time, hospitalization time, and the changes of blood routine parameters and adverse events before and after treatment were compared between the two groups. Results The total effective rate was 92.68% in the observation group versus 75.61% in the control group（P〈0.05）. The bleeding volume, hemostasis time, hospitalization time in the observation group were（412.3±83.2） m L,（7.1±2.0） h,（9.7±2.5） d, respectively, which were significantly lower than corresponding（522.8±93.7） m L,（9.5±3.0） h,（13.1±3.2） d in the control group（P〈0.05）. After the treatment, the levels of red blood cell（RBC） and hemoglobin（Hb） in the observation group were respectively（4.7±0.8）×109/L,（112.4±15.3） g/L, which were significantly higher than（3.7±0.7）×109/L and（99.2±13.6） g/L in the control group（P〈0.05）; but there was no significant difference in the incidence of nausea, vomiting, palpitation and vertigo between the two groups（P〈0.05）. Conclusion Amoxicillin combined with pantoprazole has the remarkable effect in the treatment of hemorrhagic peptic ulcer bleeding induced by dual antiplatelet therapy, which is not only conducive to the early recovery of patients, but also can improve blood, and had the advantage of good security.

关 键 词：消化道溃疡性出血 泮托拉唑 奥美拉唑 疗效 安全性 

分 类 号：R573.1[医药卫生—消化系统]