序贯口服埃索美拉唑治疗内镜黏膜下剥离术后并发症的临床研究

Clinical study of sequential oral esomeprazole treatment of endoscopic submucosal dissection postoperative complications

目的:探讨序贯口服埃索美拉唑治疗内镜黏膜下剥离术(ESD)后并发症的临床疗效。方法:选择2015年6月—2016年6月行ESD治疗的60例患者,随机分为两组,每组30例。术后均采用制酸护胃药。对照组采用40 mg奥美拉唑静脉滴注,每天2次,7 d后改为奥美拉唑肠溶片40 mg,继续口服7 d。观察组则采用40 mg埃索美拉唑静脉滴注,每天2次,7 d后改为埃索美拉唑肠溶片40 mg,继续口服7 d。观察患者术后第7天及第14天时腹部疼痛、腹胀、嗳气、恶心欲呕等症状评分的改善情况;比较患者消化道出血、创面溃疡愈合及药物不良反应情况。结果:术后患者腹部疼痛、腹胀、嗳气、恶心欲呕等症状评分均逐渐降低,溃疡面积减小,但各时间点观察组数值均更低,差异有统计学意义(P<0.05)。两组均未发现消化道出血,对照组不良反应发生率为6.67%,观察组为3.33%,组间比较差异无统计学意义(P>0.05)。结论:序贯口服埃索美拉唑可有效促进ESD术后创面愈合,优于奥美拉唑。

Objective： To investigate the clinical efficacy of sequential oral esomeprazole in the treatment of postoperative complications of endoscopic submucosal dissection（ ESD）. Methods： Sixty patients with ESD in hospital from June 2015 to June 2016 were included in the study and randomly divided into the treatment group. The control group of 30 patients using intravenous omeprazole 40 mg,2 times one day,7 days later renamed Omeprazole Enteric-coated Tablets 40 mg to oral 7 days.The observation group of 30 patients with esomeprazole 40 mg intravenous drip,2 times one days,7 days changed after esomeprazole enteric coated tablet 40 mg to oral 7 days. The postoperative 7 days and 14 days abdominal pain,abdominal distension,belching,nausea and vomiting and other symptoms score improvement; comparison of patients with gastrointestinal bleeding,wound healing and adverse drug reactions. Results： the postoperative patients with abdominal pain,abdominal distension,belching,nausea and other symptoms scores were gradually decreased,ulcer area decreased,but each time point of the observation group were significantly lower value（ P〈0. 05）. The two groups were not found in the digestive tract hemorrhage,the control group adverse reaction rate was 6. 67%,the observation group 3. 33%,group there were no significant difference（ P〈0. 05）.Conclusion： sequential oral esomeprazole ESD can effectively promote the healing of wound after operation,better than omeprazole.