内镜下金属钛夹联合不同剂量奥美拉唑在难治性消化性溃疡并出血中的疗效对比研究  

Efficacy of hemostasis with titanium clip under endoscopecombined with different doses of omeprazole in the treatment of refractory peptic ulcer with bleeding: a comparative study

作　　者：郑有花 薛晓红[1] 杨玉霞 高燕 ZHENG Youhua;XUE Xiaohong;YANG Yuxia;GAO Yan(Department of Gastroenterology,Qinghai Provincial People′s Hospital,Xining Qinghai 810000,China)

机构地区：[1]青海省人民医院消化内科,青海西宁810000

出　　处：《中国急救复苏与灾害医学杂志》2023年第1期90-93,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：青海省自然科学基金资助项目(编号:9673672)。

摘　　要：目的 对比内镜下金属钛夹联合不同剂量奥美拉唑在难治性消化性溃疡并出血中的疗效及安全性。方法 选取青海省人民医院2018年7月—2021年4月收治的61例难治性消化性溃疡并出血患者作为研究对象。以电脑随机数法将其分为高剂量组(31例)及低剂量组(30例),两组患者均行内镜下金属钛夹止血,低剂量联合奥美拉唑40 mg给药治疗,高剂量组联合奥美拉唑80 mg给药治疗,比较两组患者给药1周后的临床疗效、及时止血率、72 h出血率、治疗1周后再出血率、临床症状恢复时间、胃液pH值及不良反应。结果 高剂量组治疗有效率(96.77%)高于低剂量组(80.00%)(P<0.05);高剂量及时止血率及72 h出血率均低于低剂量组(P<0.05),两组治疗1周后再出血率比较差异无统计学意义(P>0.05);高剂量组OB转阴时间及住院天数均短于低剂量组(P<0.05);整体分析,患者胃酸pH值组间比较、时间点比较及交互作用差异均具有统计学意义(P<0.05);组间比较,高剂量组治疗24 h及72 h后胃酸pH值均高于低剂量组(P<0.05);两组患者治疗24 h及72 h后胃酸pH值均高于治疗前(P<0.05);两组不良反应发生率比较差异无统计学有意义(P>0.05)。结论 高剂量组相比于低剂量组治疗难治性消化性溃疡并出血患者,更有利于控制患者胃液分泌水平,且患者恢复时间更短且安全性良好。Objective To compare the efficacy and safety of hemostasis with titanium clip under endoscope combined with different doses of omeprazole in treatment of refractory peptic ulcer with bleeding.Methods 61 patients with refractory peptic ulcerwith bleeding underwent hemostasis with titanium clip under endoscopeand were randomly divided into 2 groups:low-dose group(31 cases) undergoing intervenousdrip of omeprazole 40 mg dissolved in 100 mL0.9% NaCl twice a day for one week,and high-dose group(30 cases) undergoing intervenousdrip of omeprazole 80 mg dissolved in 250 mL 0.9% NaCl twice a day for one week,endoscopic gastrointestinal hemorrhage and fecal occult blood pH velue of gastric juice after 24 h and 72 h were examined.The timely hemostasis rate of the high-dose group was 58.06%,significantly higher than that iof the low-dose group(29.03%,P<0.05).Results The effective rate of treatment in the high-dose group was 96.77%,significantly higher than that of the low-dose group(80.00%,P<0.05).The timely hemostasis rate of the high-dose group was 58.06%,significantly higher than that of the low-dose group(29.03%,P<0.05).The 72-hour bleeding rate of the high-dose group was 3.23%,significantly lower than that of the low-dose group(20.00%,P<0.05).There was no significant difference in the rebleeding rate after 1 week of treatmentbetween the two groups(P>0.05).The OB turning negative time and hospitalization days in the high-dose group were shorter than those in the low-dose group(P<0.05).The hospital stay of the high-dose group was(8.29±1.75) d,significantly shorter than that of the low-dose group(P<0.001).Overall analysis,the comparison of gastric acid PH value between groups,time point comparison and interaction difference are statistically display(P<0.05),comparison between groups,the gastric acid PH value of the high-dose group after 24 h and 72 h is higher than Low dose group(P<0.05).the pH value of gastric acid after 24 h and 72 h treatment in the two groups was higher than that before treatment(P<0.05).The differenc

关 键 词：难治性消化性溃疡 出血 金属钛夹 奥美拉唑 

分 类 号：R573.1[医药卫生—消化系统]