埃索美拉唑联合无肝素血液透析防治尿毒症患者上消化道出血的效果研究

Efficacy of Esomeprazole Combined with No Heparin Hemodialysis on Upper Gastrointestinal Bleeding of Uremia Patients

目的探讨早期应用埃索美拉唑联合无肝素血液透析防治尿毒症患者上消化道出血的疗效。方法将60例尿毒症患者随机分为埃索美拉唑联合无肝素血液透析组(治疗组,30例)和法莫替丁联合无肝素血液透析组(对照组,30例),观察两组患者上消化道出血的发生率,监测给药后第2、4、6天胃液pH值。结果 (1)治疗后,治疗组显效25例、有效4例、无效1例;对照组显效16例、有效8例、无效6例,两组疗效比较差异有统计学意义(P<0.01)。(2)治疗组和对照组病死率(6.7%和13.3%)比较,差异有统计学意义(P<0.01)。(3)给药后第2、4、6天两组胃液pH值比较,差异均有统计学意义(P<0.01)。(4)治疗组与对照组不良反应发生率(3.3%和16.7%)比较,差异有统计学意义(P<0.01)。结论早期应用埃索美拉唑联合无肝素血液透析可显著降低尿毒症患者上消化道出血的发生率,明显提高其胃液pH值。

Objective To evaluate the effects of esomeprazole combined with no heparin hemodialysis in treating upper gastrointestinal bleeding in uremia patients.Methods Sixty uremia patients were divided into two groups：esomeprazole combined with no heparin hemodialysis group（treatment group,n=30） and famotidine combined with no heparin hemodialysis group（control group,n=30）.Incidence of gastrointestinal bleeding was observed and the pH of gastric juice was detected on the 2nd,4th,and 6th day after administration.Results After the therapy,25 cases showed remarkable response,4 showed medium response and 1 showed no response in the treatment group,while 16 cases showed remarkable response,8 showed medium response and 6 showed no response in the control group（P0.01）.Mortality rates were statistically significant between the treatment group and the control group（6.7% vs 13.3%,P0.05）.The differences in gastric juice pH on the 2nd,4th,and 6th day after treatment were significantly different between the two groups（P0.01）.Adverse reaction rates were significantly different between the treatment group and the control group（3.3% vs 16.7%,P0.05）.Conclusion Early administration of esomeprazole combined with no heparin hemodialysis effectively decreases the incidence of gastrointestinal bleeding and increases the pH of gastric juice.