消化内镜与幽门螺杆菌四联疗法联合治疗胃溃疡出血的效果及不良反应观察  

Observation on the effect and adverse reactions of digestive endoscopy combined with Helicobacter pylori quadruple therapy in the treatment of bleeding gastric ulcer

作　　者：李煜 LI Yu(Department of Gastroenterology,Laiyang Central Hospital,Yantai 265200,China)

机构地区：[1]烟台市莱阳中心医院消化内科,265200

出　　处：《中国实用医药》2025年第2期125-128,共4页China Practical Medicine

摘　　要：目的观察对胃溃疡出血患者应用幽门螺杆菌(Hp)四联疗法联合消化内镜治疗的疗效和安全性。方法82例胃溃疡出血患者,随机分为治疗组和对照组,每组41例。对照组采用幽门螺杆菌四联疗法治疗,治疗组采用幽门螺杆菌四联疗法联合消化内镜治疗。比较两组患者溃疡愈合情况、幽门螺杆菌根除情况病情改善时间、黏膜组织学评分、不良反应发生情况。结果治疗组患者溃疡愈合率95.12%、幽门螺杆菌根除率87.80%高于对照组的75.61%、65.85%(P<0.05)。治疗组患者便血消失时间(2.58±0.22)d、止血时间(1.60±0.16)d、呕血消失时间(1.46±0.26)d、腹痛消失时间(2.19±0.33)d均短于对照组的(4.08±0.46)、(3.41±0.44)、(2.34±0.50)、(3.76±0.54)d(P<0.05)。治疗组患者治疗后黏膜厚度评分(0.24±0.06)分、腺体密度评分(1.08±0.24)分、腺体形态评分(0.66±0.15)分、炎症活动性评分(1.21±0.21)分、炎性细胞浸润评分(1.23±0.44)分均低于对照组的(0.84±0.10)、(1.38±0.43)、(1.14±0.28)、(1.78±0.38)、(1.98±0.52)分(P<0.05)。治疗组不良反应发生率4.88%低于对照组的26.83%(P<0.05)。结论对胃溃疡出血患者联合应用幽门螺杆菌四联疗法、消化内镜治疗效果良好,可促进溃疡愈合、提高幽门螺杆菌根除率,缩短病情改善时间,改善黏膜组织,降低不良反应发生率,值得推广。Objective To observe the efficacy and safety of digestive endoscopy combined with Helicobacter pylori(Hp)quadruple therapy in the treatment of bleeding gastric ulcer.Methods 82 patients with bleeding gastric ulcer were randomly divided into treatment group and control group,with 41 cases in each group.The control group was treated with Helicobacter pylori quadruple therapy,and the treatment group was treated with Helicobacter pylori quadruple therapy combined with digestive endoscopy.The ulcer healing,Helicobacter pylori eradication,time for disease improvement,mucosal histological score and adverse reactions were compared between the two groups.Results The ulcer healing rate of 95.12% and Helicobacter pylori eradication rate of 87.80% in the treatment group were higher than 75.61% and 65.85% in the control group(P<0.05).In the treatment group,the disappearance time of hematochezia was(2.58±0.22)d,the hemostasis time was(1.60±0.16)d,the disappearance time of vomiting blood was(1.46±0.26)d,and the disappearance time of abdominal pain was(2.19±0.33)d,which were shorter than(4.08±0.46),(3.41±0.44),(2.34±0.50),and(3.76±0.54)d in the control group(P<0.05).After treatment,the mucosal thickness score of the treatment group was(0.24±0.06)points,the glandular density score was(1.08±0.24)points,the glandular morphology score was(0.66±0.15)points,the inflammatory activity score was(1.21±0.21)points,and the inflammatory cell infiltration score was(1.23±0.44)points,which were lower than(0.84±0.10),(1.38±0.43),(1.14±0.28),(1.78±0.38)and(1.98±0.52)points of the control group(P<0.05).The incidence of adverse reactions of 4.88% in the treatment group was lower than 26.83% in the control group(P<0.05).Conclusion The combined application of Helicobacter pylori quadruple therapy and digestive endoscopy for patients with bleeding gastric ulcer has good effects,which can promote ulcer healing,increase Helicobacter pylori eradication rate,shorten the time for disease improvement,improve mucosal tissue,and reduce the i

关 键 词：胃溃疡出血 四联疗法 幽门螺杆菌 消化内镜 不良反应 

分 类 号：R57[医药卫生—消化系统]