两种质子泵抑制剂预防股骨头置换术后应激性溃疡对比研究

Two Kinds of Proton Pump Inhibitor for Preventing Stress Ulcers after Femoral Head Replacement

目的研究奥美拉唑和兰索拉唑2种质子泵抑制剂预防股骨头置换术后应激性溃疡的有效性和安全性。方法采用回顾性队列研究方法,将41例接受股骨头置换术患者分为奥美拉唑组22例和兰索拉唑组19例。结果奥美拉唑组无失血性休克、呕血、血红蛋白下降20 g/L、术后急腹症出现,黑便与大便隐血阳性率与应激性溃疡发生率均为4.55%(1/22);兰索拉唑组无失血性休克、呕血、黑便出现,大便隐血发生率为21.05%,血红蛋白下降20 g/L比率为5.26%,急腹症发生率为5.26%,应激性溃疡发生率为26.32%。两组患者应激性溃疡发生率存在显著性差异(P<0.05)。结论对于具有诱发应激性溃疡高危因素的患者,奥美拉唑预防应激性溃疡效果优于兰索拉唑,在血红蛋白含量、大便隐血试验、黑便、呕血、失血性休克方面具有一定差异,但无统计学意义。

Objective To study tbe effectiveness and safety of two kinds of proton pump inbibitor omeprazole and lansoprazole for pre-venting stress ulcers after femoral bead replacement. Methods 41 patients receiving femoral bead replacement were divided into tbe omerprazole group（22 cases） and lansoprazole group（19 cases） by adopting tbe retrospective cobort study metbod. Results Tbe omer-prazole group bad no case of bemorrbagic sbock,spitting blood,Hb decrease by 20 g/L and acute abdomen;positive rate of melena and fecal occult blood and tbe stress ulcer occurrence rate in tbe omerprazole group were 4. 55%（1/22）,wbile tbe lansoprazole group bad no cases of bemorrbagic sbock,spitting blood and melena,tbe occurrence rate of fecal occult blood was 21. 05%,tbe ratio of Hb de-crease by 20 g/L was 5. 26% and tbe occurrence rate of stress ulcer was 26. 32%. Tbe occurrence rate of stress ulcer bad statistical-ly significant difference between tbe two groups （ P〈0. 05 ） . Conclusion Omerprazole is better for preventing stress ulcer tban lanso-prazole in tbe patients witb bigb risk factors inducing stress ulcer,bas certain differences in tbe aspects of Hb content,fecal occult blood test,melena,spitting blood and bemorrbagic sbock,but witbout statistical significance.