内镜下止血联合不同剂量艾司奥美拉唑钠治疗急性消化性溃疡出血效果分析研究  

Effect of Endoscopic Hemostasis Combined with Intravenous Administration of Different Doses of Esomeprazole Sodium on Acute Peptic Ulcer Bleeding

作　　者：李阳 屈亚威[2] 高健翎 高智 刘海峰[2] LI Yang;QU Yawei;GAO Jianling;GAO Zhi;LIU Haifeng(Postgraduate Training Base,General Hospital of Chinese People＇s Armed Police Force,Jinzhou Medical University,Beijing 100039,China;Department of Gastroenterology,General Hospital of Chinese People＇s Armed Police Force,Beijing 100039,China)

机构地区：[1]锦州医科大学武警总医院研究生培养基地,北京市100039 [2]武警总医院消化内科,北京市100039

出　　处：《中国全科医学》2018年第35期4350-4353,共4页Chinese General Practice

基　　金：国家自然科学基金面上项目(81471700)-基于契伦科夫信号增强技术的双模式内窥镜成像方法研究;北京医卫健康公益基金会合作课题(YWJKJJHKYJJ-A608)-不同剂量艾司奥美拉唑钠联合内镜治疗急性非静脉曲张性上消化道出血疗效对比分析

摘　　要：目的比较内镜下止血联合不同剂量注射用艾司奥美拉唑钠治疗急性消化性溃疡出血的临床效果。方法选取2016年1月—2018年1月武警总医院消化内科收治的160例急性消化性溃疡出血患者,采用随机数字表法将其分为标准剂量组(研究组)和大剂量组(对照组),各80例。所有患者接受内镜下止血治疗。研究组给予注射用艾司奥美拉唑钠80 mg静脉注射+40 mg静脉滴注,每12 h 1次,维持治疗72 h。对照组给予注射用艾司奥美拉唑钠80 mg静脉注射+8 mg/h静脉持续泵入,维持治疗72 h。对比两组患者的平均止血时间、平均输血量、再出血率、平均住院时间、不良反应发生率及手术干预情况。结果两组平均止血时间、平均输血量、再出血率、平均住院时间、不良反应发生率以及转外科手术率比较,差异均无统计学意义(P>0.05)。结论对于急性消化性溃疡出血患者,内镜下止血联合标准剂量注射用艾司奥美拉唑钠间歇静脉滴注与大剂量持续泵入的止血效果相当,但前者更有利于减少医疗资源,值得临床应用与推广。ObjectiveTo explore the clinical effect of endoscopic hemostasis combined with intravenous administration of different doses of esomeprazole sodium on acute peptic ulcer bleeding（APUB）.MethodsWe enrolled 160 inpatients with APUB from Department of Gastroenterology,General Hospital of Chinese People＇s Armed Police Force from January 2016 to January 2018 and equally divided them into standard-dose group（study group） and large-dose group（control group） by the random number table.Based on endoscopic hemostasis,the study group received 3-day management including intravenous injection of esomeprazole sodium 80 mg combined with intravenous drip of esomeprazole sodium 40 mg,once every 12 hours,and the control group received 3-day management consisting of intravenous injection of esomeprazole sodium 80 mg combined with continuous infusion of esomeprazole sodium 8 mg/h by the infusion pump.We compared the indicators for evaluating the treatment effectiveness such as mean time needed for bleeding to stop,mean amount of blood transfusion,rate of re-bleeding,mean length of stay,rate of having adverse events,and rate of receiving surgical intervention between the groups.ResultsBoth groups showed no significant differences in the aforementioned indicators for evaluating the treatment effectiveness（P〉0.05）.ConclusionAlthough both regimens achieved similar hemostatic effects,we recommend intravenous administration of standard dose of esomeprazole sodium in combination with endoscopic hemostasis,for it uses less medical resources.

关 键 词：消化性溃疡出血 胃镜检查 奥美拉唑 止血 剂量 治疗结果 

分 类 号：R573.2[医药卫生—消化系统]