胃镜直视下清创后服药治疗消化性溃疡125例观察

An Analysis of Medicine Treatment After Endoscopic Depridement in 125 Patients with Peptic Ulcer

目的：观察胃镜直视下清创对消化性溃疡愈合的影响。方法：２４５例消化性溃疡中治疗组１２５例（胃溃疡５８例，十二指肠球部溃疡６７例），对照组１２０例（胃溃疡５６例，十二指肠球溃６４例）。治疗组在胃镜直视下用细胞刷反复拉刷溃疡创面，直到创面坏死苔清除干净，其后服药治疗。对照组仅用药物治疗。结果：２周后治疗组消化性溃疡愈合率为７１％，其中胃溃疡为６８％，十二指肠球溃７５％，对照组愈合率５６％（胃溃疡４９％，十二指肠球溃５８％）。１个月后治疗组愈合率为９６％（胃溃疡９４％，十二指肠球溃９８．２％），对照组为８５％（胃溃疡７２％，十二指肠球溃９１％）。治疗组的２周及１月愈合率明显高于对照组（Ｐ＜０．０５）。胃溃疡清创后愈合率明显优于十二指肠球溃。结论：胃镜直视下清创能加速溃疡愈合，对胃溃疡效果更优。

Objective: To evaluate the effect of endoscopic debridment on the healing of peptic ulcer. Methods: 245 patients with peptic ulcer were randomly allocated to treatment group( n =125) and control( n =120) in treatment group. Ulcer surface was brushed repeatedly with cell brush by endoscopy until necrosis layer of ulcer surface was cleared away and after endoscopic depridment, drug treatment was given. Control group only received drug treatment. After two weeks and a month of the above treatment, endoscopic reexaminations were performed in both groups respectively. Results: Treatment group had a ulcer healing rate of 71%, among these the gastric ulcer healing rate was 68%, and the duodenal ulcer was 75% and control group were 56%, 49%, 58% respectively after two weeks. After a month, the healing rate was 96% in treatment group(the healing rate in patients with gastric ulcer and duodenal ulcer was 94% and 98.2% respectively). In the control group, the healing rate was 85% and the healing rate of gastric ulcer and duodenal ulcer was 72% and 91% respectively. The healing rate of treatment group was markedly higher than that of control group( P <0.05). Conclusion: Gastroscopic debridment canimprove the healing rate of peptic ulcer, especially better in patients with gastric ulcer.