抑酸剂在新生儿上消化道出血中的应用

目的了解抑酸剂在新生儿上消化道出血中的疗效,对比奥美拉唑与西咪替丁治疗新生儿上消化道出血的临床效果。方法对2006年10月~2009年2月我院新生儿科收治的81例新生儿上消化道出血患儿进行回顾性分析。比较出凝血功能正常和异常患儿的上消化道出血时间;对出凝血功能正常的患儿比较奥美拉唑与西咪替丁治疗上消化道出血持续的时间。结果出凝血功能异常的上消化道出血新生儿年龄、性别、孕周、分娩方式及基础疾病等情况与出凝血功能正常的患儿相近（P〉0.05）,但出生体重较低（P〈0.05）;出凝血功能异常的上消化道出血新生儿（28例）平均出血时间明显较出凝血功能正常患儿（53例）长,分别为（3.96±2.25）d和（2.21±1.13）d,P〈0.05;凝血功能正常患儿中奥美拉唑组（27例）出血时间短于西咪替丁组（26例）,分别为（1.89±0.97）d和（2.54±1.21）d,P〈0.05。结论对上消化道出血新生儿常规进行出凝血功能检查有助于治疗方案的选择,出凝血功能异常者必须首先纠正出凝血功能异常,而对于出凝血功能正常患儿用抑酸剂有效,奥美拉唑疗效优于西咪替丁。

Application of acid inhibitor in upper gastrointestinal hemorrhage of newborn

Objective In order to get the messages of the curative effective of acid inhibitor used in upper gastrointestinal hemorrhage of newborn and contrast the eficacy of omeprazole and cimetidine in treating stress ulceration of neobron.Methods We used retrospective analysis to analyze neonatal inpatients from Oct.2006 to Feb.2009 in Chengdu children＇s hospital with upper gastrointestinal hemorrhage.All 81 patients were examed bleeding and coagulating function.To treat them with omeprazole and Cimetidine respectively as the same time control the basic disease,stabilize internal environment and stop bleeding.The bleeding times of upper gastrointestinal hemorrhage in the patients of normal bleeding and coagulating function was compared with the abnormal patients.The duration of bleeding in those with normal bleeding and coagulating function was compared the cases of using omeprazole with Cimetidine.Results The average of bleeding times were markedly longer in patients of abnormal bleeding and coagulating function（28cases） than in normal function patients（53cases） with（3.96±2.25）days and（2.21±1.13） days respectively.The bleeding times in those with normal bleeding and coagulating function to the patients of using omeprazole（27cases）were shorter than the patients of Cimetidine（26cases） with（1.89±0.97）days and（2.54±1.21） days respectively.Conclusion It is important to exam bleeding and coagulating function to those neonates with upper gastrointestinal hemorrhage before you starting to treat the patients.To those with abnormal bleeding and coagulating function should correct their coagulating disfunction firstly.While to those with normal bleeding and coagulating function the acid inhibitor were effective,and omeprazole was prior to Cimetidine.