法莫替丁与奥美拉唑辅助治疗消化性溃疡内镜止血的疗效比较

目的比较内镜治疗胃、十二指肠溃疡出血后早期阶段(前3 d)分别注射法莫替丁和奥美拉唑防治再出血的效果。方法我院消化内科住院的106例胃、十二指肠溃疡出血患者,接受内镜止血治疗后,随机分配为两组,分别予以注射奥美拉唑(20 mg,Bid)或法莫替丁(20 mg,Bid)辅助治疗。注射酸抑制剂治疗1周后分别口服相应药物持续6周,随访2年。结果 106例患者均完成了治疗及2年的随诊,106例患者首次内镜止血的成功率为103/106(97.2%)。观察治疗期间总止血成功率为84.9%(90/116),其中法莫替丁组和奥美拉唑组各有9例和7例发生再出血,两组止血成功率分别为83.0%(44/53)和86.8%(46/53),差异无统计学意义。两组患者在住院时间、死亡率和禁食天数方面差异无统计学意义。结论奥美拉唑和法莫替丁辅助治疗消化性溃疡内镜止血具有同等的临床效果。

Effects of famotidine and omeprazole on adjuvant therapies after endoscopic hemostasis in bleeding gastroduodenal ulcers

Objective ] To compared the effects of famotidine and omeprazole injected during the early phase （the first 3 days） on cessation of bleeding and prevention of its recurrence in patients who underwent endoscopic therapy for gastroduodenal ulcer bleeding. Methods ] 106 patients who were hospitalized at our department with bleeding gastroduodenal ulcers and underwent endoscopic therapy were randomly assigned to receive injections of omeprazole or famotidine. Injection of acid suppressants was switched on the eighth day to the oral administration of omeprazole or famotidine last for 6 weeks and for 2-year follow-up. Resluts ] The overall success rate of 106 patients for endoscopic hemostasis was 103/106 （97.2%）. The success rate of hemostasis and prevention of recurrent ulcer bleeding by different type of acid suppressant following endoscopic hemostasis was 46/53 （86.8%） in omeprazole group and 44/53 （83.0%） in famotidine group, yielding an overall rate of 90/116 （84.9%）. No statistical significance in the hemostatic effect was observed between the groups. There were also no statistical differences in the duration of hospital days, mortality rate and the number of fasting days between the two groups. Conclusion ] Omeprazole and famotidine may have similar effects to an adjuvant therapy for preventing rebleeding from endoscopically treated upper gastrointestinal bleeding.