不同剂量艾司奥美拉唑联合内镜止血治疗急性消化性溃疡出血的疗效对比分析

Comparison and Analysis of the Efficacy of Different Doses of Omeprazole Combined With Endoscopic Hemostasis in the Treatment of Acute Peptic Ulcer Bleeding

目的:对比分析不同用量艾司奥美拉唑联用内镜止血对急性消化性溃疡出血的疗效,为未来艾司奥美拉唑的剂量选择提供依据,以提升治疗的有效性及安全性。方法:选择2016年6月—2018年9月于我院接受门诊治疗后入院的急性消化性溃疡出血患者90例,依照随机数字表法分为标准剂量组(45例)和大剂量组(45例)。内镜止血治疗后,大剂量组采用大剂量艾司奥美拉唑(40 mg静脉注射,2次/d+8 mg/h静脉泵注,治疗72小时)治疗,标准剂量组采用标准用量艾司奥美拉唑(40 mg静脉注射,2次/d,治疗72小时)治疗,对比两组止血时间、输血量、住院时间与不良反应(恶心、呕吐、腹痛、皮疹)发生率及再出血率。结果:标准剂量组患者止血时间、输血量与住院时间[(1.54±0.62)天、(2.43±1.18)U、(7.16±1.43)天]与大剂量组[(1.62±0.78)天、(2.42±1.12)U、(7.21±1.65)天]比较,差异无统计学意义(P>0.05);治疗期间,标准剂量组恶心、呕吐、腹痛、皮疹的发生率(0.00%、6.67%、2.22%、0.00%)与大剂量组(4.44%、2.22%、4.44%、4.44%)比较,差异无统计学意义(P>0.05);治疗72小时结束后的2周内,标准剂量组再出血率(6.67%)与大剂量组(4.44%)比较,差异无统计学意义(P>0.05)。结论:大剂量与标准剂量艾司奥美拉唑联用内镜止血对急性消化性溃疡出血的疗效与安全性相当,但标准剂量有利于减少药物消耗,可作为首选用量。

Objective:To compare and analyze the effects of different dosages of omeprazole combined with endoscopic hemostasis on acute peptic ulcer bleeding,to provide a basis for the future dose selection of omeprazole,to improve the effectiveness and safety of treatment.Methods:90 patients with acute peptic ulcer bleeding who were treated in our hospital from June 2016 to September 2018 were selected and divided into a standard dose group (45 cases) and a high dose group (45 cases) according to random number table method.After endoscopic hemostasis treatment,the high-dose group was treated with high-dose omeprazole (40 mg intravenous injection,2 times/d+8 mg/h intravenous injection,treated for 72 hours),and the standard-dose group was given the standard dosage of omeprazole (40 mg static push,2 times/d,treated for 72 h) for treatment,the incidence of hemostasis,blood transfusion,hospitalization time and adverse reactions (nausea,vomiting,abdominal pain,rash) and rebleeding rate were compared between the two groups.Results:The hemostasis time,blood transfusion volume and hospitalization time of patients in the standard dose group were[(1.54±0.62) d,(2.43±1.18)U,(7.16±1.43)d],compared with[(1.62±0.78)d,(2.42±1.12)U,(7.21±1.65)d]of the high dose group,the difference was not statistically significant (P>0.05);During treatment,the incidence of nausea,vomiting,abdominal pain,and rash in the standard-dose group was (0.00%,6.67%,2.22%,0.00%),compared with the high-dose group’s (4.44%,2.22%,4.44%,4.44%),the difference was not statistically significant (P>0.05);Within 2 weeks after the end of 72 hours of treatment,the rebleeding rate in the standard-dose group was (6.67%),compared with the high-dose group’s (4.44%),the difference was not statistically significant (P>0.05).Conclusion:High-dose and standard-dose omeprazole combined with endoscopic hemostasis has equivalent efficacy and safety to acute peptic ulcer bleeding,but the standard dose is beneficial to reduce drug consumption and can be used as the preferred dosage.