两种质子泵抑制剂治疗内镜止血后上消化道出血的疗效比较
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摘要
目的比较注射用艾司奥美拉唑与注射用奥美拉唑治疗内镜止血后的非静脉曲张性上消化道出血的疗效及安全性。方法将我院2018年1—12月收治的100例急性非静脉曲张性上消化道出血患者行内镜止血后,随机分为艾司奥美拉唑组(50例)和奥美拉唑组(50例),分别静脉滴注艾司奥美拉唑和奥美拉唑80 mg后,再分别以艾司奥美拉唑和奥美拉唑静脉泵入治疗72 h,比较两组患者治疗后临床症状及体征的缓解情况和相关指标的变化,评价治疗后3 d内,两组患者的临床止血效果,记录治疗过程中不良反应发生情况。结果艾司奥美拉唑组患者治疗3 d内的呕血、黑便次数均低于奥美拉唑组患者,差异有统计学意义(P <0.05)。两组临床治疗的总有效率以及不良反应的发生率相比较,差异均无统计学意义(P> 0.05)。但艾司奥美拉唑组治疗的显效率为92%(46/50),高于奥美拉唑组68%(34/50),差异有统计学意义(P <0.05)。结论艾司奥美拉唑和奥美拉唑治疗内镜止血后的上消化道出血具有良好的有效性和安全性,但艾司奥美拉唑可以更快速地改善患者的临床症状。
Objective To compare the efficacy and safety of esomeprazole and omeprazole in the treatment of non-variceal upper gastrointestinal bleeding after endoscopic hemostasis. Methods A total of 100 cases of non-variceal upper gastrointestinal bleeding after endoscopic hemostasis from January to December 2018 were recruited. And they were divided into group esomeprazole of 50 cases and group omeprazole of 50 cases randomly. Patients of the two groups were treated with esomeprazole and omeprazole by intravenous drop respectively, and then by venous pump respectively for 72 hours. The details of improvements of clinical symptoms and signs and changes of related indicators after treatment in the two groups were recorded, as well as the occurrence of adverse reactions during treatment. The efficacy of the treatment of the two groups in 3 days was analyzed. Results The number of hematemesis and blackstool in esomeprazole group was lower than that in omeprazole group within 3 days of treatment, and the difference was statistically significant(P< 0.05). There was no significant difference in the total effective rate and the incidence of adverse reactions between the two groups(P > 0.05). However,the effective rate of esomeprazole group was 92%(46/50), higher than that of omeprazole group 68%(34/50), the difference was statistically significant(P <0.05). Conclusion Esomeprazole and omeprazole are effective and safe in the treatment of upper gastrointestinal bleeding after endoscopic hemostasis, but Esomeprazole can improve clinical symptoms more quickly.
Objective To compare the efficacy and safety of esomeprazole and omeprazole in the treatment of non-variceal upper gastrointestinal bleeding after endoscopic hemostasis. Methods A total of 100 cases of non-variceal upper gastrointestinal bleeding after endoscopic hemostasis from January to December 2018 were recruited. And they were divided into group esomeprazole of 50 cases and group omeprazole of 50 cases randomly. Patients of the two groups were treated with esomeprazole and omeprazole by intravenous drop respectively, and then by venous pump respectively for 72 hours. The details of improvements of clinical symptoms and signs and changes of related indicators after treatment in the two groups were recorded, as well as the occurrence of adverse reactions during treatment. The efficacy of the treatment of the two groups in 3 days was analyzed. Results The number of hematemesis and blackstool in esomeprazole group was lower than that in omeprazole group within 3 days of treatment, and the difference was statistically significant(P< 0.05). There was no significant difference in the total effective rate and the incidence of adverse reactions between the two groups(P > 0.05). However,the effective rate of esomeprazole group was 92%(46/50), higher than that of omeprazole group 68%(34/50), the difference was statistically significant(P <0.05). Conclusion Esomeprazole and omeprazole are effective and safe in the treatment of upper gastrointestinal bleeding after endoscopic hemostasis, but Esomeprazole can improve clinical symptoms more quickly.
引文
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[9]王晓辉.艾司奥美拉唑治疗消化性溃疡致上消化道出血的临床效果观察[J].临床医药文献杂志,2017,4(60):11850-11851.
[10]Beales I.Recent advances in the management of peptic ulcer bleeding[J].F1000Res,2017,6(F1000 Faculty Rev):1763.
[11]Nagashima K,Tominaga K,Fukushi K,et al.Recent trends in the occurrence of bleeding gastric and duodenal ulcers under the Japanese evidence-based clinical practice guideline for peptic ulcer disease[J].JGH Open,2018,2(6):255-261.
[12]Bai Y,Chen DF,Wang RQ,et al.Intravenous Esomeprazole for Prevention of Peptic Ulcer Rebleeding:A Randomized Trial in Chinese Patients[J].Adv Ther,2015,32(11):1160-1176.
[13]Kavitt RT,Lipowska AM,Anyane-Yeboa A,et al.Diagnosis and Treatment of Peptic Ulcer Disease[J].Am J Med,2019,132(4):447-456.
[14]Zuo Y,Wang S,Cui X,et al.Therapeutic Endoscopy in Combination with Quadruple Therapy in Treating Bleeding Caused by Gastric Ulcer[J].Pakistan Journal of Medical Sciences,2018,34(1):10-14.
[2]江堤,廖素环,邓惠钊,等.内镜下荷包缝合术在消化性溃疡并出血中的临床应用[J].中华消化内镜杂志,2018,35(6):415-418.
[3]Karstensen JG,Ebigbo A,Aabakken L,et al.Nonvariceal upper gastrointestinal hemorrhage:European Society of Gastrointestina Endoscopy(ESGE)Cascade Guideline[J].Endosc Int Open,2018,6(10):E1256-E1263.
[4]中华内科杂志社,中华医学杂志社,中华消化杂志社,等.急性非静脉曲张性上消化道出血诊治指南(2015年,南昌)[J].中华消化杂志,2015,35(12):793-798.
[5]刘畅,彭刚,邹瑞政,等.艾司奥美拉唑肠溶片治疗消化性溃疡合并幽门螺杆菌感染的临床研究[J].中国临床药理学杂志,2018,34(19):2276-2282.
[6]陈嘉韦.艾司奥美拉唑钠与奥美拉唑钠治疗急性上消化道出血的疗效及安全性比较[J].临床研究,2019,27(1):85-87.
[7]高淑娟,高银虎,许君望.埃索美拉唑与奥美拉唑治疗幽门螺杆菌相关性胃溃疡82例[J].陕西医学杂志,2017,46(9):1284-1286.
[8]王有广,席向利,席向艳.泮托拉唑钠注射液治疗消化性溃疡合并上消化道出血的临床效果[J].中外医疗杂志,2018,16(3):47-78.
[9]王晓辉.艾司奥美拉唑治疗消化性溃疡致上消化道出血的临床效果观察[J].临床医药文献杂志,2017,4(60):11850-11851.
[10]Beales I.Recent advances in the management of peptic ulcer bleeding[J].F1000Res,2017,6(F1000 Faculty Rev):1763.
[11]Nagashima K,Tominaga K,Fukushi K,et al.Recent trends in the occurrence of bleeding gastric and duodenal ulcers under the Japanese evidence-based clinical practice guideline for peptic ulcer disease[J].JGH Open,2018,2(6):255-261.
[12]Bai Y,Chen DF,Wang RQ,et al.Intravenous Esomeprazole for Prevention of Peptic Ulcer Rebleeding:A Randomized Trial in Chinese Patients[J].Adv Ther,2015,32(11):1160-1176.
[13]Kavitt RT,Lipowska AM,Anyane-Yeboa A,et al.Diagnosis and Treatment of Peptic Ulcer Disease[J].Am J Med,2019,132(4):447-456.
[14]Zuo Y,Wang S,Cui X,et al.Therapeutic Endoscopy in Combination with Quadruple Therapy in Treating Bleeding Caused by Gastric Ulcer[J].Pakistan Journal of Medical Sciences,2018,34(1):10-14.