上消化道出血合并痛风急性发作的临床分析  

Clinical analysis of upper gastrointestinal bleeding complicated with acute gout attack

作　　者：宋慧琴 何文芳[1] 李睿[2] 卢慧玲[2] 梁常俊 SONG Hui-qin;HE Wen-fang;LI Rui(Department of Geriatrics,Guangdong Yingde People’s Hospital,Yingde 513000,China)

机构地区：[1]广东省英德市人民医院老年科,513000 [2]广东省英德市人民医院消化科,513000

出　　处：《中国现代药物应用》2018年第7期15-17,共3页Chinese Journal of Modern Drug Application

基　　金：影响中年男性2型糖尿病患者血清睾酮水平的相关因素研究(项目编号2015B090)

摘　　要：目的观察上消化道出血合并痛风急性发作患者的临床表现,并分析相应的临床治疗方法。方法回顾性分析50例上消化道出血合并痛风急性发作患者的临床资料。结果 50例患者中,出血量为235~1576 ml,平均出血量为(668.73±105.29)ml;平均体温为(37.51±0.89)℃。50例患者均禁食禁水1~3 d,并采取静脉补液的方式进行辅助治疗,补液量为(2531.57±239.66)ml。50例患者经常规治疗后,21例患者症状得到显著改善,针对症状未改善的29例患者使用地塞米松进行治疗,根据体温及关节肿痛症状,地塞米松静脉注射1~2 d后停用,其中6例患者发生消化道再出血,主要表现为黑便,6例患者将静脉质子泵抑制剂(PPIs)改为注射用艾司奥美拉唑钠(艾速平),每12小时静脉点滴治疗1次。所有患者症状均得到有效控制,且在服药期间各项临床症状基本消失,治愈率为100.00%。结论针对上消化道出血合并痛风急性发作患者的临床治疗,应当根据患者的临床症状和医生的诊治经验,为患者制定最佳治疗方案。Objective To observe the clinical manifestation of patients with upper gastrointestinal bleeding and acute gout attack,and analyze corresponding clinical treatment method.Methods The clinical data of 50 patients with upper gastrointestinal bleeding and acute gout attack was retrospectively analyzed.Results 50 patients had bleeding volume as 235~1576 ml,with mean bleeding volume as(668.73±105.29)ml,and mean body temperature as(37.51±0.89)℃.50 cases of the patients were fasted and banned water for 1~3 d,and received adjuvant therapy by intravenous infusion.The volume of infusion was(2531.57±239.66)ml.After regular treatment,there were 21 patients had significant improvement in symptoms.For 29 patients without improvement in symptoms,dexamethasone was used for treatment.According to body temperature and joint swelling and pain symptoms,dexamethasone was stopped after intravenous injection for 1~2 d.Among them,6 patients had digestive tract rebleeding,mainly manifested as black stool.6 patients had intravenous proton pump inhibitors(PPIs)changed to esomeprazole sodium(Aisuping),and intravenously dripped once every 12 hours.All the patients’symptoms were effectively controlled,and the clinical symptoms were basically disappeared during the period of medication,and cure rate was 100.00%.Conclusion For the clinical treatment of patients with upper gastrointestinal bleeding and acute gout,clinical symptoms of patients and doctors’experience should be based on to develop the best treatment options.

关 键 词：上消化道出血 痛风 急性发作 临床分析 

分 类 号：R573.2[医药卫生—消化系统] R589.7[医药卫生—内科学]