艾司奥美拉唑与泮托拉唑预防内镜下食管胃静脉曲张硬化剂或组织胶注射治疗术后早期出血效果比较

Comparison of the efficacy of esomeprazole and pantoprazole in preventing early postoperative bleeding after endoscopic sclerotherapy or tissue adhesive injection

目的比较艾司奥美拉唑与泮托拉唑在预防内镜下食管胃底静脉曲张硬化剂或组织胶注射治疗术后早期出血的效果、有效率和不良反应率的差异。方法选取我院2016年8月至2019年6月收治的197例食管胃底曲张静脉破裂出血行内镜下食管胃底静脉曲张硬化剂或组织胶注射治疗术的患者作为研究对象,随机分为观察组(艾司奥美拉唑)和对照组(泮托拉唑),对比2组患者治疗后的早期出血率,治疗有效率,不良反应发生率,1周后胃镜下的表现的差异。结果观察组早期出血率(8%)在6周时明显高于对照组(1%),差异具有统计学意义(P<0.05);2组患者的治疗总有效率分别为98%,97%,差异无统计学意义(P>0.05);2组患者的不良反应发生率分别为5%,3%,差异无统计学意义(P>0.05);2组患者1周后胃镜下表现总有效率分别为93%,92%,差异无统计学意义(P>0.05)。结论在内镜下食管胃底静脉曲张硬化剂或组织胶注射治疗术后的患者中,艾司奥美拉唑预防术后早期出血效果优于泮托拉唑,以6周时效果明显,可有效缓解临床症状,降低再住院率,值得临床推广。

Objective To compare the effect,effective rate and adverse reaction rate of esomeprazole and pantoprazole in the treatment of early bleeding after endoscopic injection sclerosis(EIS)or tissue adhesive injection.Methods One hundred and ninty-seven patients with gastroesophageal variceal bleeding accepted EIS or tissue adhesive injection from August 2018 to June 2019 were divided into experimental group and control group.Esomeprazole and pantoprazole were injected respectively.The early bleeding rate,therapeutic effective rate,adverse reaction rate and endoscopic manifestations after 1 week of treatment were compared.Results The early bleeding rate of the experimental group(8%)at 6 week was significantly higher than that of the control group(1%),and the difference was statistically significant(P<0.05);the total effective rates of the two groups were 98%and 97%respectively,with no statistically significant difference(P>0.05);the adverse reaction rates in the two groups were 5%and 3%respectively,with no statistically significant difference(P>0.05);after 1 week of treatment,the total effective rates of endoscopic manifestations in the 2 groups were 93%and 92%respectively,with no statistically significant difference(P>0.05).Conclusion Among the patients treated by EIS or tissue adhesive injection,esomeprazole has a better effect than pantoprazole in preventing early postoperative bleeding.The effect is significant at 6 week,which can effectively relieve clinical symptoms and reduce the rate of rehospitalization,and it is worthy of clinical practice.