临床合理用药杂志
臨床閤理用藥雜誌
림상합리용약잡지
CHINESE JOURNAL OF CLINICAL RATIONAL DRUG USE
2015年
4期
3-4,6
,共3页
张玉茹%王伟%何俊彦%王平
張玉茹%王偉%何俊彥%王平
장옥여%왕위%하준언%왕평
消化性溃疡大出血%内镜止血%高危患者%埃索美拉唑,不同剂量%护理
消化性潰瘍大齣血%內鏡止血%高危患者%埃索美拉唑,不同劑量%護理
소화성궤양대출혈%내경지혈%고위환자%애색미랍서,불동제량%호리
Peptic ulcer bleeding%Endoscopic hemostasis%High-risk patients%Esomeprazole,Different doses%Care
目的：对比观察不同剂量埃索美拉唑治疗高危型内镜成功止血后PUB临床效果。方法将200例消化性溃疡大出血内镜成功止血后高危患者随机分为观察组和对照组各100例。观察组于内镜成功止血后30min内给予埃索美拉唑80mg静脉推注＋8mg／L静脉滴注维持72h。对照组给予埃索美拉唑40mg／d静脉滴注＋生理盐水补液72h的标准PPI治疗，之后2组均接受埃索美拉唑20mg口服，每天2次。2组均给予密切的观察和护理。观察2组临床疗效，输血量、住院时间、72h、30d的再出血率、手术率、病死率和不良反应事件发生率。结果观察组总有效率为96％高于对照组的83％，差异有统计学意义（P＜0．05）。观察组72h、30d的再出血率低于对照组；输血量少于对照组，住院时间短于对照组，手术率低于对照组，病死率低于对照组，差异均有统计学意义（ P＜0．05）。2组不良反应事件发生率差异无统计学意义（ P＞0．05）。结论消化性溃疡大出血内镜成功止血后高危患者采用大剂量埃索美拉唑治疗联合密切的观察和护理临床疗效较好，可减少再出血率、手术率、病死率，减少输血量，缩短住院时间，且不良事件发生率低，具有较好的疗效，值得临床推广应用。
目的：對比觀察不同劑量埃索美拉唑治療高危型內鏡成功止血後PUB臨床效果。方法將200例消化性潰瘍大齣血內鏡成功止血後高危患者隨機分為觀察組和對照組各100例。觀察組于內鏡成功止血後30min內給予埃索美拉唑80mg靜脈推註＋8mg／L靜脈滴註維持72h。對照組給予埃索美拉唑40mg／d靜脈滴註＋生理鹽水補液72h的標準PPI治療，之後2組均接受埃索美拉唑20mg口服，每天2次。2組均給予密切的觀察和護理。觀察2組臨床療效，輸血量、住院時間、72h、30d的再齣血率、手術率、病死率和不良反應事件髮生率。結果觀察組總有效率為96％高于對照組的83％，差異有統計學意義（P＜0．05）。觀察組72h、30d的再齣血率低于對照組；輸血量少于對照組，住院時間短于對照組，手術率低于對照組，病死率低于對照組，差異均有統計學意義（ P＜0．05）。2組不良反應事件髮生率差異無統計學意義（ P＞0．05）。結論消化性潰瘍大齣血內鏡成功止血後高危患者採用大劑量埃索美拉唑治療聯閤密切的觀察和護理臨床療效較好，可減少再齣血率、手術率、病死率，減少輸血量，縮短住院時間，且不良事件髮生率低，具有較好的療效，值得臨床推廣應用。
목적：대비관찰불동제량애색미랍서치료고위형내경성공지혈후PUB림상효과。방법장200례소화성궤양대출혈내경성공지혈후고위환자수궤분위관찰조화대조조각100례。관찰조우내경성공지혈후30min내급여애색미랍서80mg정맥추주＋8mg／L정맥적주유지72h。대조조급여애색미랍서40mg／d정맥적주＋생리염수보액72h적표준PPI치료，지후2조균접수애색미랍서20mg구복，매천2차。2조균급여밀절적관찰화호리。관찰2조림상료효，수혈량、주원시간、72h、30d적재출혈솔、수술솔、병사솔화불량반응사건발생솔。결과관찰조총유효솔위96％고우대조조적83％，차이유통계학의의（P＜0．05）。관찰조72h、30d적재출혈솔저우대조조；수혈량소우대조조，주원시간단우대조조，수술솔저우대조조，병사솔저우대조조，차이균유통계학의의（ P＜0．05）。2조불량반응사건발생솔차이무통계학의의（ P＞0．05）。결론소화성궤양대출혈내경성공지혈후고위환자채용대제량애색미랍서치료연합밀절적관찰화호리림상료효교호，가감소재출혈솔、수술솔、병사솔，감소수혈량，축단주원시간，차불량사건발생솔저，구유교호적료효，치득림상추엄응용。
Objective Comparative observation of various doses of esomeprazole in high-risk PUB after successful en-doscopic .Methods 200 patients with high-risk patients peptic ulcer massive hemorrhage were randomly divided into observa-tion group and control group ,each of 100 cases.Observation group was treated by esomeprazole 80mg/d,bolus,and 8mg/L in-travenous infusion to maintain 72h.Control group was treated by esomeprazole 40mg/d,bolus,and normal saline to maintain 72h.Group 2 underwent esomeprazole 20mg oral,twice daily.Group 2 were both given close observation and care .Results The total efficiency of observation group (96%) was higher than that of control group the difference was statistically significant (P<0.05).The 72h,30d rebleeding rate of observation group were lower than that of control group ,the amount of blood trans-fusion and hospital stay of observation group was less than that of control group ,the surgery rate,mortality rate were lower than that of control group,the difference was statistically significant (P<0.05).The incidence of adverse events of 2 groups has no statistically(P>0.05).Conclusion The high-dose esomeprazole in high-risk patients with peptic ulcer massive hemorrhage treated by endoscopic hemostasis ,can reduce the rebleeding ,operation rate,mortality,reduce the blood transfusion ,shorter hos-pital stay ,and a low incidence of adverse events ,has an good effect ,worthy of clinical application .
