内镜下注射结合静脉注射奥美拉唑对消化性溃疡活动性出血的疗效

目的观察内镜注射治疗联用不同剂量的奥美拉唑(OME)及单用OME对消化性溃疡活动性出血患者的疗效。方法采用随机对照的方法。把101例内镜下有活动性出血的消化性溃疡出血患者，随机分为3组，分别接受①内镜注射止血治疗联用每天2次静脉注射OME40mg，疗程5d；②内镜注射止血治疗联用每天1次静脉注射OME40mg，疗程5d；③单用每天2次静脉注射OME40mg，疗程5d。治疗期间观察患者的止血时间、输血量、再出血情况及住院时间。结果3组患者的再出血率为3/35(8.6％)，9/32(28.1％)，15/34(44.1％)，差异有显著性(P＜0.05)；手术率1/35(2.9％)，2/32(6.3％)，7/34(20.6％)，差异有显著性(P＜0.05)；死亡率0/34(0％)，1/32(3.1％)，1/34(2.9％)，差异无显著性(P＞0.05)；输血量(3.7±2.7)单位(每单位=200m1)，(5±2.5)单位，(2.5±2.4)单位，差异无显著性(P＞0.05)；止血时间分别为(1.8±1.5)d，(3.8±1.9)d，(5.5±2.1)d，差异有显著性(P＜0.05)；住院时间(8.7±2.5)d，(15.7±6.9)d，(17.1±8.3)d，差异有显著性(P＜0.05)。结论内镜注射治疗联用每天2次静脉注射40mgOME疗效最好o

Effect of endoscopic therapy and omeprazole injection on patients with active bleeding peptic ulcer

Objective To determine the effect of endoscopic injection and omeprazole on control of bleeding in peptic ulcer patients with active bleeding or nonbleeding visible vessels. Mehtods One hundred and one peptic ulcer patients with active bleeding or nonbleeding visible vessels (Forrest Ia, Ⅰb, Ⅱa) were randomlyenrolled into three groups. In the first group, the patients were given ndoscopic injection of hemostatic, and then followed by a 40mg omeprazole intravenous injection twice dally for 5 days. In the second group, the pa-tients were given endoscopic injection hemostasis therapy, and then followed by a 40 mg omeprazole intravenous injection once daily for 5 days. While in the third group, the patients were only given 40 mg omeprazole in-travenous injection twice daily for 5 days. Results Rebleeding occurred in 3 patients 8.6% , 9 patients(28.1% ) and 15/34(44. 1% ) in the first, second and third group respectively, P ＜ 0. 05. There was a tendency for patients in the first group to acquire less time for hemostasis and hospital stay than those of the other two groups. The blood transfussion, surgery rate and mortality rate were similar between these three groups.Conclusion Endoscopic therapy combined with omeprazole (80 mg/d) an effectively reduce the rebleedingrate, hospital stay and hemostasis time in patients with bleeding peptic ulcer. It was recommended for the treatment of patients with bleeding peptic ulcer.