埃索美拉唑静脉治疗上消化道溃疡合并出血的回顾性研究

A retrospective study of esomeprazole in the treatment of peptic ulcer gastrointestinal hemorrhage

目的本研究旨在观察埃索美拉唑在治疗消化性溃疡上消化道出血的疗效。方法回顾我院自2010年5月～2014年12月收治消化性溃疡合并上消化道出血患者的治疗情况,其中应用埃索美拉唑40例,奥美拉唑43例,于急性出血期进行静脉注射40 mg,每6小时1次,胃镜证实控制出血后改静脉用药频次至每8小时1次,用药4 d后改口服剂型同类药物维持20 mg,每日2次,6～8周,评价临床症状、实验室检查指标、胃液p H值及1年内复发率。结果两组患者输血量、止血时间、住院时间、治疗前血红蛋白水平、5 d后血红蛋白水平、5 d内显效率之间差异无统计学意义（P〉0.05）;其p H〉4时间以及1年内复发率差异有统计学意义（P〈0.05）。结论埃索美拉唑与奥美拉唑在治疗上消化道溃疡合并出血方面均有较好疗效,且在改善胃内酸性环境、减少远期复发方面略有优势。

Objective To view the effect of esomeprazole in the treatment of peptic ulcer gastrointestinal hemorrhage.Methods A total of 40 patients were treated by esomeprazole and 43 patients were treated by omeprazole from May2010 to December 2014 were selected. During the acute upper gastrointestinal bleeding the esomeprazole or omeprazole were used through an intravenous drip 40 mg q6 h. After the cease of bleeding were confirmed by gastroscopy, the frequency of intravenous was changed to q8 h for 4 days, then patients changed in oral dosage form with the same drugs by20 mg q12 h, for 6-8 weeks. The clinical symptoms, laboratory parameters, gastric p H and relapse ratio within one year were evaluated. Results The blood transfusion, bleeding time, length of hospital stay, hemoglobin level before treatment,5 days after hemoglobin levels, 5 days of remarkable efficiency of two groups had no significant difference（P〈0.05）;concerning p H4 time, and the relapse rate within one year had significant difference（P〈0.05）. Conclusion Esomeprazole and omeprazole in the treatment of digestive ulcer with hemorrhage has the same effect, but the esomeprazole is more effective than omeprazole in adjusting the acidic environment of the stomach and reducing the long-term recurrence.