不同剂量埃索美拉唑预防消化性溃疡并出血内镜止血后再出血的临床观察

Observation of different doses of esomeprazole for the prevention of recurrent haemorrhage after endoscopic haemostasis of bleeding peptic ulcers

目的比较不同剂量埃索美拉唑预防消化性溃疡并出血内镜止血后再出血的效果。方法 108例消化性溃疡并出血患者经肾上腺素粘膜下注射联合电凝或止血夹治疗成功止血后,随机分成2组。大剂量组给予埃索美拉唑80 mg静推+8 mg/h输注,维持72 h;标准剂量组给予埃索美拉唑80 mg静推+40 mg静推,q12 h,维持72 h。两组患者随后均给予埃索美拉唑20 mg,1次/d,维持治疗27 d。结果大剂量组72 h、7 d、30d再出血率分别为5.6%、9.3%、9.3%,与标准剂量组(7.4%、9.3%、11.1%)比较差异无统计学意义(P>0.05)。两组患者住院时间、外科手术率、死亡率比较差异无统计学意义(P>0.05)。结论不同剂量埃索美拉唑预防高危消化性溃疡并出血内镜止血后再出血的效果相当。

Objective To compare the preventive effect of different doses of esomeprazole on hemorrhage af-ter endoscopic haemostasis. Methods A total of 108 patients with bleeding ulcers undergoing endoscopic treatment with epinephrine injection and heater probe thermocoagulation or clip were randomized to receive a high-dose regimen （80 mg bolus,followed by esomeprazole 8 mg/h infusion,n=54） or a standard-dose regimen （ esomeprazole 40 mg bolus q12h,n=54）. After 72 h,all patients were given 20 mg esomeprazole daily orally for 27 d. Results The rates of recurrent bleeding in 72 h,7 d and 30 d separately were 5. 6%,9. 3%,9. 3% in high dose group,and 7. 4%,9. 3%, 11. 1% in standard dose group（P〉0. 05）. There was no significant difference in hospital stay time,the rate of surgical interventions and mortality between the two groups. Conclusion Different doses of esomeprazole show similar effect on the prevention of recurrent haemorrhage after endoscopic haemostasis in high-risk bleeding peptic ulcers.