CAJ | 학술논문

目的：探讨一种对上消化道出血安全有效的快速止血方法。方法：87例患者随机分A、B两组：A组（n＝47）用奥美拉唑40 mg静注，每12 h一次，连用3 d后改为口服；同时口服0．4 g／L去甲肾上腺素盐水20 mL，每1 h一次，连用6次，然后根据出血情况调整给药时间（每2～4 h一次），止血后停用；B组（n＝40），奥美拉唑用法同A组，不用去甲肾上腺素。结果：A组的止血效果明显优于B组，差异有显著性（Hc＝5．852 P＜0．05）；A组的快速止血率（显效率）和总有效率均明显高于B组（68．1％vs45．0％，93．6％，vs77．5％），差异均有显著性（P＜0．05）。未见明显副作用，治疗12 h后查胃镜均未发现有胃粘膜坏死现象。结论：静注奥美拉唑联合口服大剂量去甲肾上腺素对上消化道大出血有快速止血作用，适用于广大基层医院和院前急救。
목적：탐토일충대상소화도출혈안전유효적쾌속지혈방법。방법：87례환자수궤분A、B량조：A조（n＝47）용오미랍서40 mg정주，매12 h일차，련용3 d후개위구복；동시구복0．4 g／L거갑신상선소염수20 mL，매1 h일차，련용6차，연후근거출혈정황조정급약시간（매2～4 h일차），지혈후정용；B조（n＝40），오미랍서용법동A조，불용거갑신상선소。결과：A조적지혈효과명현우우B조，차이유현저성（Hc＝5．852 P＜0．05）；A조적쾌속지혈솔（현효솔）화총유효솔균명현고우B조（68．1％vs45．0％，93．6％，vs77．5％），차이균유현저성（P＜0．05）。미견명현부작용，치료12 h후사위경균미발현유위점막배사현상。결론：정주오미랍서연합구복대제량거갑신상선소대상소화도대출혈유쾌속지혈작용，괄용우엄대기층의원화원전급구。
Objective：To probe into a safe effective rapid hemostasia for upper gastrointestinal hemorrhage（UGIH）．Methods：87 patients with UGIH were randomly divided into two groups（Group A and Group B）．The patients in Group A（n＝47）were intravenously given omeprazole of 40 mg every 12 hours combined with 0．4 g／L noradrenaline 20 mL orally every hour within initial 6 hours，followed with every 2 to 4 hours according to hemorrhagic conditions．Omeprazole was orally given instead after three days．Once hemostasis could be gained，noradrenaline was discontinued．The patients in Group B（n＝40）received only omeprazole as its usage and dosage as in Group A．Results：The efficacy of hemosatasis in Group A was significantly better than that in Group B（Hc＝5．852 P＜0．05）．The rate of rapid hemostasis （within 12 hours）and total effective rate were substantially greater in Group A compared with those in Group B（68．1％ vs 45．0％，93．6％ vs 77．5％，respectively，P＜0．05）．No obvious side-effects were observed．Gastric mucosa necrosis under gastroscopy did not occur in Group A when high dosage of noradrenaline had been orally given for 12 hours．Conclusion：Intravenous omeprazole combined with high dosage of orally noradrenaline may play rapid hemostatic role in upper gastrointestinal hemorrhage and suits to critical hemostasis of UGIH at local hospital before the victims will be taken to medical center．