胃铋镁联合泮托拉唑治疗内镜黏膜下剥离术后溃疡的效果

Effect of Compound Bismuth and Magnesium Granules combined with Pantoprazole in the treatment of post endoscopic submucosal dissection ulcer

目的探索胃铋镁联合泮托拉唑治疗内镜黏膜下剥离术（ESD）后溃疡的效果。方法选取2015年5月~2016年5月长江大学附属第一医院收治的ESD患者87例,采用简单随机化方法将其随机分为实验组（43例）和对照组（44例）。对照组给予注射用泮托拉唑钠40 mg/次,1次/d,持续注射7 d;7 d后改为泮托拉唑钠肠溶胶囊40 mg/次,1次/d。实验组在对照组的基础上,术后第2天加用胃铋镁颗粒3 g/次,3次/d。总疗程4周。观察两组第1、3、7天上腹部症状改善情况、给药4周溃疡愈合及不良反应发生情况。结果 ESD术后第3、7天,两组上腹部症状均较术后第1天明显减轻（P〈0.05）,实验组腹痛、腹胀症状评分低于对照组（P〈0.05）。实验组溃疡缩小率、溃疡愈合率高于对照组,差异均有统计学意义（P〈0.05）。两组均未发生严重不良反应,两组不良反应发生率比较差异无统计学意义（P〉0.05）。结论胃铋镁联合泮托拉唑治疗ESD术后溃疡效果要优于单独使用泮托拉唑,不增加不良反应,且能有效改善ESD术后上腹部症状,促进ESD术后溃疡的愈合,是一种安全、有效的方法。

Objective To investigate the effect of Compound Bismuth and Magnesium Granules combined with Pantoprazole in the treatment of post endoscopic submucosal dissection（ESD） ulcer. Methods Eighty-seven patients received ESD admitted to the First Affiliated Hospital of Yangtze University from May 2015 to May 2016 were selected,they were randomly divided into experimental group（43 cases） and control group（44 cases） by simple randomized method. The control group was given Pantoprazole Sodium for Injection, 40 mg every time, once a day, continuous injection for 7 days, then it was adjusted as Pantoprazole Sodium Enteric Capsules after 7 d, 40 mg every time, once a day. On basis of control group, the experimental group was added with Compound Bismuth and Magnesium Granules on the second day after operation, 3 g every time, three times a day, the total course was 4 weeks. The improvement of upper abdominal symptoms on the first, third and seventh day, the conditions of ulcer healing after treatment for 4 weeks and adverse reactions in the two groups were observed. Results The upper abdominal symptoms 3, 7 days after ESD in the two groups were significantly reduced than those 1 day after ESD（P〈0.05）, while the scores of abdominal pain and abdominal distension of experimental group were lower than those of control group（P〈0.05）. The decreasing rate of ulcer area and the healing rate of ulcer of experimental group were higher than those of control group, with statistically significant differences（P〈0.05）. There was no severe adverse reactions in two groups, and the incidence of adverse reactions between two groups had no statistically significant difference（P〈0.05）. Conclusion Compound Bismuth and Magnesium Granules combined with Pantoprazole in the treatment of post ESD ulcer has a better effect than the single use of Pantoprazole, without increasing adverse reactions, and it can significantly improve the upper abdominal symptoms after ESD, promote the healing of post ESD ulcer, which is a safe and effective method.