3种质子泵抑制剂分别联合奥曲肽治疗非静脉曲张性上消化道出血的临床研究  

Clinical study of 3 proton pump inhibitors combined with octreotide separately for the treatment of non-variceal upper gastrointestinal bleeding

作　　者：黄永华 HUANG Yonghua(Department of Gastroenterology,Huidong People’s Hospital,Affiliated Huidong Hospital of Guangdong Medical University,Guangdong,Huidong 516300,China)

机构地区：[1]广东省惠东县人民医院广东医科大学附属惠东医院消化内科,广东惠东516300

出　　处：《中国医药科学》2022年第1期175-178,共4页China Medicine And Pharmacy

基　　金：广东省惠州市科技计划项目(200416104579859)。

摘　　要：目的探究3种质子泵抑制剂分别联合奥曲肽治疗非静脉曲张性上消化道出血的临床效果。方法开展前瞻性研究,选择2020年4—10月于惠东县人民医院就诊的90例非静脉曲张性上消化道出血患者为研究对象,采用随机数字表法将患者分为A、B和C组,每组各30例。A组采用奥美拉唑+奥曲肽治疗,B组采用兰索拉唑+奥曲肽治疗,C组采用艾司奥美拉唑+奥曲肽治疗,比较三组治疗总有效率、48 h再出血率、不良反应发生率、止血时间以及治疗前后不同时间点胃p H值变化情况。结果三组治疗总有效率、48 h再出血率、不良反应总发生率比较,差异无统计学意义(P>0.05);C组止血时间短于A、B组,差异有统计学意义(P<0.05)。治疗前,三组的胃p H值比较,差异无统计学意义(P>0.05),但C组治疗6、12、24 h的胃p H值明显高于A、B组(P<0.05)。结论奥美拉唑、兰索拉唑、艾司奥美拉唑联合奥曲肽治疗非静脉曲张性上消化道出血的疗效及安全性相当,但艾司奥美拉唑在提高胃液p H值、快速止血方面更具优势,值得推广应用。Objective To probe into the clinical efficacy of 3 proton pump inhibitors combined with octreotide respectively in the treatment of non-variceal upper gastrointestinal bleeding.Methods A total of 90 patients with non-variceal upper gastrointestinal bleeding who attended Huidong People’s Hospital from April to October 2020 were selected as the study subjects of a prospective study.The patients were divided into group A,B and C by using the random number table method,with 30 cases in each group.The group A was treated with omeprazole and octreotide,the group B was treated with lansoprazole and octreotide,and group C was treated with esomeprazole and octreotide.The total effective rate of treatment,rebleeding rate within 48 h,incidence of adverse reactions,duration of hemostasis,and changes in gastric pH at different time points before and after treatment were compared among the three groups.Results There were no statistically significant differences in the total effective rate of treatment,rebleeding rate within 48 h and total incidence of adverse reactions among the three groups(P>0.05).The duration of hemostasis in group C was shorter than that in group A and group B,with statistically significant difference(P<0.05).Before treatment,there was no statistically significant difference between the gastric pH of the three groups(P>0.05),but the gastric pH of group C was significantly higher than that of group A and group B at 6 h,12 h and 24 h of treatment,with statistically significant difference(P<0.05).Conclusion The efficacy and safety of omeprazole,lansoprazole and esomeprazole combined with octreotide separately in the treatment of non-variceal upper gastrointestinal bleeding are comparable,but esomeprazole is more advantageous in raising gastric pH and rapid hemostasis,which is worthy of promotion and application.

关 键 词：非静脉曲张性上消化道出血 奥曲肽 奥美拉唑 兰索拉唑 艾司奥美拉唑 

分 类 号：R573.2[医药卫生—消化系统]