CAJ | 학술논문

目的：观察全肠外营养(total parenteral nutrition，TPN)添加丙氨酰谷氨酰胺治疗消化性溃疡所致上消化道出血的疗效。方法以2011年1月-2013年12月间入住该院的198例消化性溃疡出血患者为研究组，以2011年1月-2013年12月间入住该院的74例消化性溃疡出血患者为对照组，所有患者均于入院24 h内行急诊胃镜检查，明确诊断后两组均经常规治疗，根据病情给予禁食、补液、营养支持、抑酸、止血、保护胃粘膜等治疗。研究组给予丙氨酰谷氨酰胺(力太)20 g加入500 mL全肠外营养液中静脉输注Qd。对照组给予同样500 mL全肠外营养液但不加入力太。一周后复查胃镜，观察两组患者胃镜下的溃疡分期及再出血情况。结果272例消化性溃疡出血患者初次检查镜下溃疡均为活动期，其中研究组A1期182例(91.92%)，A2期16例(8.08%)；复查胃镜有142例(71.72%)患者进入愈合期，其中H期140例(70.70%)，S期2例(1.01%)，溃疡愈合率为71.72%。对照组初次检查镜下溃疡分期：A1期52例(70.27%)，A2期22例(29.73%)；复查胃镜有38例(51.35%)患者进入愈合期，其中H期26例(35.14%)，S期12例(16.22%)，溃疡愈合率为51.35%。两组愈合率比较差异有统计学意义。研究组一周内再出血18例(9.09%)；对照组一周内再出血20例(27.03%)；两组再出血率比较差异有统计学意义。结论对于消化性溃疡合并出血患者，常规治疗的同时加用含丙氨酰谷氨酰胺肠外营养可以促进溃疡愈合，降低再出血率。
목적：관찰전장외영양(total parenteral nutrition，TPN)첨가병안선곡안선알치료소화성궤양소치상소화도출혈적료효。방법이2011년1월-2013년12월간입주해원적198례소화성궤양출혈환자위연구조，이2011년1월-2013년12월간입주해원적74례소화성궤양출혈환자위대조조，소유환자균우입원24 h내행급진위경검사，명학진단후량조균경상규치료，근거병정급여금식、보액、영양지지、억산、지혈、보호위점막등치료。연구조급여병안선곡안선알(력태)20 g가입500 mL전장외영양액중정맥수주Qd。대조조급여동양500 mL전장외영양액단불가입력태。일주후복사위경，관찰량조환자위경하적궤양분기급재출혈정황。결과272례소화성궤양출혈환자초차검사경하궤양균위활동기，기중연구조A1기182례(91.92%)，A2기16례(8.08%)；복사위경유142례(71.72%)환자진입유합기，기중H기140례(70.70%)，S기2례(1.01%)，궤양유합솔위71.72%。대조조초차검사경하궤양분기：A1기52례(70.27%)，A2기22례(29.73%)；복사위경유38례(51.35%)환자진입유합기，기중H기26례(35.14%)，S기12례(16.22%)，궤양유합솔위51.35%。량조유합솔비교차이유통계학의의。연구조일주내재출혈18례(9.09%)；대조조일주내재출혈20례(27.03%)；량조재출혈솔비교차이유통계학의의。결론대우소화성궤양합병출혈환자，상규치료적동시가용함병안선곡안선알장외영양가이촉진궤양유합，강저재출혈솔。
Objective Efficacy of Alanyl Glutamine total parenteral nutrition treatment of upper gastrointestinal hemorrhage caused by peptic ulcer. Methods 198 cases of peptic ulcer bleeding in patients admitted to our hospital from Jan 2011 to Dec 2013 as the study group, 64 cases of peptic ulcer bleeding in patients admitted to our hospital from Jan 2011 to Dec 2013 as the control group, All patients were received endoscopy examination in admitted to hospital 24 hours. After diagnosis in both groups , according to the disease, the conventional treatment was given fasting, including of the treatment of fluid replacement, nutritional support, antisecretory, stop bleeding, protect the gastric mucosa.the study group was given alanyl-glutamine (20g) by adding 500 mL of total parenteral nutrition infusion Qd, Control group was given the same 500 mL of total parenteral nutrition but does not join the alanyl-glutamine , rechecked after one week, Observe the ulcer stage and the Re-bleeding. Results 272 patients of peptic ulcer bleeding with initial endoscopy examination are in active phase, Among study group , A1 182 case (91.92%), A2 16 cases (8.08%);which rechecked of endoscopy examination are in healing phase ,a total of 142 cases (71.72%) , H 140 cases (70.70%), S 2 cases (1.01%),ulcer healing rate is 71.72%. Control group, first check the endoscopic ulcer stage, A1 52 case(70.27%),A2 22 case(29.73%),which rechecked of endoscopy examination are in healing phase ,a total of 38 cases (51.35%), H 26 cases (35.14%), S 12 cases (16.22%), ulcer healing rate is 51.35%. The two groups of healing rate difference was statistically significant. Rebleeding in 18 cases (9.09%) within one week of the study group;control group, bleeding in 20 cases (27.03%) within a week;two groups of re-bleeding rate difference was statistically significant. Conclusions For patients with peptic ulcer bleeding, routine treatment and containing alanyl glutamine parenteral nutrition can promote ulcer healing, reduce the re-bleeding rate.