洛赛克治疗老年人脑出血并发应激性溃疡出血的疗效观察

目的：评价洛赛克在治疗老年人脑出血并发应激性溃疡出血的疗效和安全性．方法：洛赛克组（男69例，女49例，年龄60岁~92岁）接受洛赛克40mg静注，2次／日．信法丁组（男51例，女47例，年龄60岁~90岁）接受信法丁20mg＋5％GS250ml静滴，2次／日，二级疗程约为6天．结果：洛赛克组总有效率83．9％．信法丁组为66．3％（P＜0．01）。对应激性溃疡的出血量＜800ml，脑出血部位为壳核．丘脑．脑叶，出血量＜60ml的治疗中，海赛克的疗效明显优于信法丁（P＜0．01）．在应激性溃疡的出血量＞800ml脑出血部位为桥脑、小脑、脑室出血、出血量＞60ml的治疗时，二组的总有效率相似（P＞0．05）．在应用中，未发现洛赛克对各重要器官的功能和并存症造成影响，实验室检查无改变，副作用轻微．二组病人的性别、年龄、应激性溃疡的出血量、脑出血量．脑出血部位的分布具有可比性（P＞0．05）.结论：在脑出血部位为壳核、丘脑、脑叶，脑出血量＜60ml，出血量＜800ml的应激性溃疡的治疗中，洛赛克是一种可供优先选择的抑酸止血药物；对脑出血部位为桥脑．小脑、脑室，脑出血量＞60ml，出血量＞800ml的应激性溃疡的治疗时，在使用洛赛克的同时应加强针对脑出血的处理。

Therapeutic Assessment of Losec in Treating Elderly Patients with Cerebral Hemorrhage Complicating Bleeding of Stress Ulcer

Objechve:The purpose of the clinical study is to evaluate the efficacy and safety of Losec in the treatment of elderiy patients with cerebral hemrrhage complicating bleeding of stress ulcer.Methods:216 patients were randomly divided into two groups. Group 1 (n=118) treated with Losec (40mg iv injection twice daily) for six days. Group 2 (n=98) treated with Fanohdine (20mg in 5% glucose solution 250ml iv infusion twice daily) for six days. Results: The overall clinical efficacy rates of group 1and group 2 were 83.9% and 66.3% respechvely. The difference of efficacy rates between group 1 and group 2 was stahshcally sighficant (P <0.01). Each group was further divided into subgroup with the quantety of bleeding of ulcer, the location and the quatity of cerebral hemorrhage. The results revealed that the efficacy rate of group 1 was higher as assessed by the quantity of bleeding of ulcer <800ml, the quantity of bleeding of cerebral hemorrhage <60ml and location of putamen, thalamus and cerebral lohe.No major clinical or laboratory side effect was noted in all sttdied pahents.Conclusion: Losec is the drug of first choice for the stoppage of bleeding of stress ulcer as : 1) The quantity of bleeding of stress ulcer is less than 800ml, 2) Location of cerebral hemorrhage is putamen, thalanus and cerebra lobe, 3) The quantity of cerebral hemorrhage is less than 60ml.