埃索美拉唑治疗高危老年溃疡性上消化道出血的研究

目的观察大剂量与常规剂量埃索美拉唑治疗高危老年溃疡性上消化道出血的有效性。方法以2010年6月至2013年8月在我院老年医学科住院的96例溃疡性上消化道出血的高危（Rockall评分〉5分）老年患者为研究对象,将其随机分为治疗组和对照组,2组患者均在内镜下成功的止血,2组患者的一般治疗方案相同,治疗组采用1次静滴埃索美拉唑80 mg后（30 min）,接着以8 mg/h的速度持续静脉泵入埃索美拉唑,71.5 h后改为口服埃索美拉唑40 mg（1次/d）,持续观察至第30天;对照组静滴埃索美拉唑80 mg（1次/d）,3 d后改为口服埃索美拉唑40 mg（1次/d）,持续观察至第30天,观察2组的再出血率、死亡率、平均住院日及平均住院费用。结果与对照组相比,治疗组的再出血率、死亡率、平均住院日及平均住院费用均有明显的降低（P均〈0.05）。结论对高危的老年溃疡性上消化道出血患者而言,静脉大剂量使用埃索美拉唑是有效、合理的。

Effect of esomeprazole on peptic ulcer bleeding in elderly patients with high-risk

Objective To evaluate the efficacy of high-dose or regular-dose esomeprazole for high-risk elderly patients with peptic ulcer bleeding. Methods From June 2010 to August 2013, 96 high-risk elderly patients （ Rockall score〉5） with peptic ulcer bleeding were divided into test group （48 cases） and control group （48 cases）. After successful endoscopic haemostasis for the two groups,the test group received intravenous high-dose esomeprozole（ 80 mg infusion over 30 min, then 8 mg,/h for 71.5 h）, and the control group received intravenous esomeprozole 80 mg/d, with both groups receiving oral esomeprazole 40 mg once daily from days 4 to 30. The rebleeding rate, mortality, average hospital stay and average cost of the two groups were observed and analysed. Results Compared with the control group, the rebleeding rate, mortality, average hospital stay and average cost were reduced in the test group （P〈0. 05）. Conclusions Intravenous high-dose esomeprazole is effective and rational for high-risk elderly patients with peptic ulcer bleeding.