不同剂量雷贝拉唑钠注射液治疗非胃食管静脉曲张型上消化道出血的临床效果

Clinical efficacy of different doses of rabeprazole sodium injection in the treatment of non-gastroesophageal-variceal upper gastrointestinal hemorrhage

目的研究不同剂量雷贝拉唑钠注射液在非胃食管静脉曲张型上消化道出血中的应用价值。方法选择医院收治的60例非胃食管静脉曲张型上消化道出血患者为研究对象,患者均行消化内镜止血。通过随机抽签将其分为观察组和对照组,各30例。观察组内镜治疗后静脉推注40 mg雷贝拉唑钠注射液,之后维持8 mg/h,对照组静脉推注20 mg雷贝拉唑钠注射液,之后维持4 mg/h。比较两组的治疗效果。结果观察组显效率明显高于对照组,复发率明显低于对照组(P<0.05);两组治疗总有效率之间无显著差异(P>0.05)。两组胃肠道pH均在给药2 h时达到峰值;且观察组给药2 h后各时间点的胃肠道pH值均明显高于对照组(P<0.05)。治疗后,观察组胃窦黏膜炎症分级明显优于对照组(P<0.05)。两组药物不良反应总发生率比较,差异无统计学意义(P>0.05)。结论雷贝拉唑钠注射液治疗非胃食管静脉曲张型上消化道出血的效果具有剂量依耐性,高剂量可显著缩短止血时间,减低再出血复发率,且不会增加药物不良反应,值得临床推广。

Objective To study the application value of different doses of rabeprazole sodium injection in non-gastroesophageal-variceal upper gastrointestinal hemorrhage. Methods Sixty patients with non-gastroesophageal-varicealupper gastrointestinal hemorrhage in the hospital were selected as the study objects, and they were treated with digestiveendoscopic hemostasis. All patients were divided into observation group and control group by random draw, with 30 cases ineach group. The observation group was given 40 mg rabeprazole sodium injection intravenously after endoscopic therapy, andthen maintained8 mg/h. The control group was given 20 mg rabeprazole sodium injection intravenously, and then maintained4 mg/h. The therapeutic effects of the two groups were compared. Results The excellent effective rate of the observation groupwas significantly higher than that of the control group, and the recurrence rate was significantly lower than that of the controlgroup（P〈0.05）. There was no significant difference in the total effective rate of treatment between the two groups（P〉0.05）.The pH value of gastrointestinal tract in both groups reached the peak value at 2h after administration, and the pH values ofgastrointestinal tract in the observation group after 2h of administration were significantly higher than those in the controlgroup（P〈0.05）. After treatment, the inflammatory grading of gastric antral mucosa in the observation group was significantlybetter than that in the control group（P〈0.05）. There was no significant difference in the total incidence of adverse reactions ofdrug between the two groups（P〉0.05）. Conclusion Rabeprazole sodium injection in the treatment of non-gastroesophageal-variceal upper gastrointestinal hemorrhage has a dose -dependent effect, the high dose can significantly shorten thehemostasis time, reduce the recurrence rate of rehemorrhage, and will not increase adverse drug reactions. It is worthy ofclinical promotion.