CAJ | 학술논문

[目的]观察无痛内镜下注射止血联合大剂量洛赛克治疗消化性溃疡出血的临床效果。[方法]选择诊断为消化性溃疡出血患者90例，随机分为大剂量洛赛克治疗组（A组）、无痛内镜止血联合常规剂量洛赛克治疗组（B组）、无痛内镜止血联合大剂量洛赛克治疗组（C组），每组30例。A组患者用洛赛克40 m g静脉推注，每日3次，连续5 d；B组患者于内镜检查前先用洛赛克40 mg静脉推注，于异丙酚镇静下行内镜检查出血点，注射1／10000肾上腺素止血，内镜止血后继续用洛赛克40 m g静脉推注，每日2次，连续5 d；C组患者除内镜止血后静脉推注洛赛克40 m g ，每日2次改为每日3次外，其余同B组。[结果]与A组比较，B、C组的止血时间缩短、再出血率下降、手术率及住院时间降低，差异有统计学意义（P＜0．05）；与B组比较，C组的止血时间缩短、再出血率下降、手术率及住院时间降低，差异有统计学意义（ P＜0.05）。[结论]无痛内镜下注射止血联合大剂量洛赛克治疗消化性溃疡出血安全有效，符合基层医院的条件，也符合患者舒适化医疗的需求，值得在基层医院推广。
[목적]관찰무통내경하주사지혈연합대제량락새극치료소화성궤양출혈적림상효과。[방법]선택진단위소화성궤양출혈환자90례，수궤분위대제량락새극치료조（A조）、무통내경지혈연합상규제량락새극치료조（B조）、무통내경지혈연합대제량락새극치료조（C조），매조30례。A조환자용락새극40 m g정맥추주，매일3차，련속5 d；B조환자우내경검사전선용락새극40 mg정맥추주，우이병분진정하행내경검사출혈점，주사1／10000신상선소지혈，내경지혈후계속용락새극40 m g정맥추주，매일2차，련속5 d；C조환자제내경지혈후정맥추주락새극40 m g ，매일2차개위매일3차외，기여동B조。[결과]여A조비교，B、C조적지혈시간축단、재출혈솔하강、수술솔급주원시간강저，차이유통계학의의（P＜0．05）；여B조비교，C조적지혈시간축단、재출혈솔하강、수술솔급주원시간강저，차이유통계학의의（ P＜0.05）。[결론]무통내경하주사지혈연합대제량락새극치료소화성궤양출혈안전유효，부합기층의원적조건，야부합환자서괄화의료적수구，치득재기층의원추엄。
Objective]To observe the clinical effect of treatment with the anesthesia endoscopic injection combined with large dose losec for peptic ulcer bleeding.[Methods]Total of 90 peptic ulcer patients ,were randomly divided into 3 groups(n= 30):large doses losec group(group A) ,with losec 40 mg intravenous injection ,3 times a day for five days ;anesthesia endoscopy injection combine with conventional dose of losec for the treatment group(group B).The patient accepted losec 40 mg intravenous injection before endoscopic examination ,sedation with propofol ,and 1/10 000 epinephrine injected to stop bleeding ,then accepted losec 40 mg intravenous injection after endoscopic hemostasis ,2 times a day for five consecutive day ;Anesthesia endoscopy hemostasis combine with large dose of los for the treatment group (group C):losec 40 mg intra‐venous injection before endoscopic examination ,continue to use losec 40 mg intravenous injection after en‐doscopic hemostasis ,3 times a day for five consecutive day.The others treatment was similar to group B.[Results]Compared with group A ,the hemostatic time in B and C group were shortened ,and bleeding rate were declined ,operation rate and the length of time were reduced ,the differences were statistically signifi‐cant(P< 0.05).Compared with group B ,bleeding time in group C was shortened ,bleeding rate was de‐clined ,operation rate and the length of time were reduced ,the differences were statistically significant (P<0.05).[Conclusion]Anesthesia endoscopic injection combined with high dose of losec for peptic ulcer hem‐orrhage is safe and effective ,meets the requirements of basic‐level hospitals ,also meet the demand of pa‐tients comfortable personalized medical ,is worthy of popularizing in basic‐level hospitals.