埃索美拉唑治疗非甾体类抗炎药物所致消化性溃疡出血的研究

目的 比较埃索美拉唑为主的联合用药方案治疗非甾体类抗炎药物(NSAIDs)导致的消化性溃疡并发出血的临床疗效及相关的不良反应。 方法 选择2012年1月—2015年6月云南省第三人民医院消化内科收治的496例因服用NSAIDs并经急诊胃镜检查证实为消化性溃疡并发出血的患者作为研究对象，所有患者按照随机表法分为2组:埃索美拉唑治疗组280例(应用埃索美拉唑针剂联合白眉蛇毒血凝酶粉针剂及口服或鼻饲冻干粉血凝酶治疗)，奥美拉唑治疗组216例(应用奥美拉唑针剂联合白眉蛇毒血凝酶粉针剂及口服或鼻饲冻干粉血凝酶治疗)。比较2组的临床疗效、临床症状消失时间以及不良反应发生率。 结果 2组临床总有效率分别为97.85%、88.88%。埃索美拉唑治疗组显著高于奥美拉唑治疗组，差异具有统计学意义(P＜0.05)；2组临床症状平均消失时间分别为(3.2±1.5) d、(4.8±1.3) d，埃索美拉唑治疗组时间明显短于奥美拉唑治疗组，差异具有统计学意义(P＜0.05)；2组患者不良反应发生率差异无统计学意义(P＞0.05)。 结论 埃索美拉唑联合白眉蛇毒血凝酶、冻干血凝酶粉治疗NSAIDs致消化性溃疡出血的临床疗效优于奥美拉唑联合用药方案，止血效果明确，可有效地缓解患者病情，并缩短患者入住重症监护病房(ICU)的时间，是较理想的急诊救治处置措施。 

Clinical efficacy of Esomeprazole on nonsteroidal anti-inflammatory drugs caused peptic ulcer bleeding

Objective To analyze clinical haemostatic effect and incidences of adverse reactions of Esomeprazole treatment for patients who suffered from peptic ulcer bleeding because of taking nonsteroidal anti-inflammatory drugs. Methods From January,2012 to June,2015,496 cases of peptic ulcer with upper gastrointestinal haemorrhage who visited our digestive department receiving treatment were randomly divided into two groups:Esomeprazole group(280 patients) and control group of Omeprazole(216 patients) were treated with different treatment regimen.The efficacy,adverse reactions of test group and control group were compared. Results The clinical total effective rate of test group and control group were 97.85% and 88.88%,respectively.Test group was significantly higher than control group (chi-square test,P<0.05).The average disappearance time of clinical symptoms in test group and control group were (3.2±1.5)d and (4.8±1.3)d,respectively.Test group was significantly shorter than control group by analysis of variance(P<0.05).There was no significant difference in adverse reaction rate between test group and control group (chi-square test,P>0.05). Conclusion Esomeprazole combined with hemocoagulase treatment gastrointestinal bleeding caused by nonsteroidal anti-inflammatory drugs is significantly better than omeprazole combined with hemocoagulase.Test group,which has hemostatic effect exactly,can effectively shorten the time of the patients stay in EICU and is the ideal disposal measures.