不同压力高压氧综合治疗胃部巨大溃疡疗效观察

Clinical observation of hyperbaric oxygen with different pressures coupled with comprehensive treatment on extensive gastric ulcer

目的观察常规药物治疗及不同压力高压氧（HBO）综合治疗胃部巨大溃疡的临床疗效，为选择合适的治疗压力提供依据。方法经电子胃镜检查确诊为胃部巨大溃疡的24例患者，在患者知情同意的情况下，按患者意愿分为常规治疗组、0．20MPaHBO综合治疗组、0．25MPaHBO综合治疗组，每组8例。治疗干预第8周复查电子胃镜，测定并比较各组溃疡直径，评价临床症状改善情况。采用SPSS11．5统计软件包行数据分析，组间率的比较行χ2检验。结果各组治疗后溃疡直径均较治疗前缩小（P〈0．01）；其中0．25MPaHBO综合治疗组治疗后溃疡直径[（0．12±0．01）cm]缩小明显，与常规治疗组治疗后溃疡直径[（0．29±0．11）cm]比较差异有统计学意义（P〈0．01）；与0．20MPaHBO综合治疗组治疗后溃疡直径[（0．17±0．04）cm]比较差异有统计学意义（P〈0．05）。0．25MPaHBO综合治疗组的临床有效率（临床症状消失＋临床缓解）明显高于常规治疗组（χ2=10．132，P〈0．05）。结论HBO可与常规抗胃溃疡药物产生协同作用，加快溃疡愈合速度，临床有效率高，选择相对较高的氧压效果更优。

Objective To observe the therapeutic effect of HBO coupled with comprehensive drug treatment on extensive gastric ulcer, with the ultimate aim to select proper therapeutic pressures for enhancement of treatment efficiency. Methods Twenty-four patients diagnosed to be extensive gastric ulcer with electron gastroscope were divided on volunteer basis into the conventional therapy group （ with conventional pharmacotherapy）, the 0.20 MPa HBO comprehensive treatment group （0.20 MPa HBO treatment coupled with conventional pharmacotherapy） and the 0.25 MPa HBO comprehensive treatment group （0.25 MPa HBO treatment coupled with conventional pharmacotherapy）, each consisting of 8 cases. Reexamination with electron gastroscope was performed 8 weeks after treatment intervention, to measure the diameters of the gastric ulcers and evaluate the improvement of clinical symptoms, and finally comparisons were made between groups. Data analysis was dealt with SPSS 11.5 software kit and χ2 testing. Results The diameter of the ulcers in all the patients reduced following treatment （ P 〈 0.01 ）. The diameter of ulcers in patients of the 0.25 MPa HBO group reduced more significantly, when compared with the conventional therapy group （P 〈 0. 01 ）. Differences could also be seen, when compared with 0.20 MPa HBO group （ P 〈 0. 05 ）. The therapeutic effect of 0.25 MPa HBO group was significantly higher than that of the conventional therapy group （χ2 = 10. 132, P = 0. 038）. Conclusions HBO seemed to have synergistic effect with conventional pharmacotherapy in the treatment of extensive gastric ulcer, accelerating the healing and increasing clinical efficiency. Better results could be achieved with higher oxygen pressure.