奥美拉唑治疗非静脉曲张性上消化道出血最佳剂量分析

The Efficacy and Optimal Dose Analysis of the Treatment of Oromeprazole for Non-Varicose Gastrointestinal Hemorrhage

目的:探讨分析非静脉曲张性上消化道出血应用奥美拉唑治疗的效果及最佳剂量。方法:将2015年4月至2017年4月在佛山市南海区第六人民医院消化内科治疗的86例非静脉曲张性上消化道出血患者随机分为两组,在常规治疗的基础上,对照组采用大剂量奥美拉唑80 mg静脉推注,再以8 mg·h-1的速度持续静脉泵注72 h,观察组采用小剂量奥美拉唑40 mg静脉滴注,之后每12 h静滴1次,连续72 h;比较两组患者的治疗效果、止血情况、各项指标情况和不良反应。结果:观察组患者治疗总有效率为93.02%,对照组为88.37%,观察组略高,但组间比较,差异无统计学意义(P>0.05)。观察组患者治疗后止血时间、输血量、48 h后再出血率与对照组相比均明显降低,收缩压、心率、血肌酐、血红蛋白与对照组相比均明显较高;不良反应发生率明显低于对照组,差异均具有统计学意义(P<0.05)。结论:非静脉曲张性上消化道出血应用小剂量和大剂量奥美拉唑均有良好止血效果,但小剂量止血速度更快,对血压、心率、血红蛋白、血肌酐的影响更小,利于患者的早期恢复。

Objective To investigate the effect and optimal dose analysis of the treatment of oomeprazole for non-venous varicose upper gastrointestinal hemorrhage. Methods In April 2015-April 2017 in our hospital of medical treatment of 86 cases of non varicose veins in patients with upper gastrointestinal hemorrhage were randomly divided into two groups, on the basis of conventional treatment, control group using high-dose omeprazole 80 mg intravenous injection, to 8 mg/h speed continuous intravenous injection pump 72 h, observation group with small dose of omeprazole 40 mg intravenous drip,every 12 h after static drop one, for 72 h; the treatment effect of two groups of patients was compared. Results The observed group treatment was 93.02 % and the control group was 88.37 % and the observation group was slightly higher, but the difference between the two groups was not significant(P > 0.05). After treatment, the hemostasis time, transfusion volume and rebleeding rate of the observation group were significantly lower than those of the control group after treatment. The systolic blood pressure, heart rate, serum creatinine and hemoglobin were significantly higher in the observation group than those in the control group. Adverse reactions were significantly lower than the control group, the difference was statistically significant(P < 0.05). Conclusion The application of gastrointestinal bleeding varices sex low-dose and high-dose omeprazole has good hemostatic effect, but the small dose of hemostatic faster, on blood pressure, heart rate, the smaller the influence of hemoglobin, serum creatinine, conducive to the early recovery of patients.