周磊+苏楚霞+李淳南+丁字乐

[摘要]目的 探讨无痛内镜下注射止血联合大剂量埃索美拉唑治疗消化性溃疡出血的临床效果。方法 选取2015年3月～2017年2月我院收治的消化性溃疡出血患者90例，随机分为A组（大剂量埃索美拉唑治疗，30例）、B组（无痛内镜下注射止血联合常规剂量埃索美拉唑治疗，30例）、C组（无痛内镜下注射止血联合大剂量埃索美拉唑治疗，30例），比较三组患者止血时间、住院时间、住院费用及再次出血和手术发生率。结果 A组患者止血时间、住院时间、住院费用高于B、C两组，B组止血时间、住院时间、住院费用高于C组（P<0.01）。A组患者再次出血发生率高于C组，手术率高于B、C两组（P<0.05）。结论 无痛内镜下注射止血联合大剂量埃索美拉唑在消化性溃疡出血患者的治疗中可提高止血效果，降低再次出血发生率。

[关键词]消化性溃疡；出血；无痛内镜；埃索美拉唑

[中图分类号] R573.1 [文献标识码] A [文章编号] 1674-4721（2017）09（a）-0020-03

Clinical study of painless endoscopic injection of hemostasis combined with high dose Esomeprazole in the treatment of peptic ulcer bleeding

ZHOU Lei1 SU Chu-xia1 LI Chun-nan1 DING Zi-le2

1.Department of Gastroenterology，the People′s Hospital of Chao an District in Chaozhou City，Guangdong Province，Chaozhou 515638，China；2.Department of Anesthesiology，the People′s Hospital of Chao an District in Chaozhou City，Guangdong Province，Chaozhou 515638，China

[Abstract]Objective To investigate the clinical efficacy of painless endoscopic injection of hemostasis combined with high-dose Esomeprazole in the treatment of peptic ulcer bleeding.Methods 90 case of peptic ulcer bleeding patients in our hospital from March 2015 to February 2017 were selected and randomly divided into group A（30 patients with high-dose Esomeprazole），group B（painless endoscopic injection of hemostatic combined with conventional doses of Esomeprazole，30 patients），group C（painless endoscopic injection of hemostasis combined with high-dose Esomeprazole treatment，30 cases），The three groups of stop bleeding time，length of stay，hospital costs and re-bleeding and surgery were compared.Results The time of stop bleeding，hospitalization and hospital costs were higher in group A than those in group B and group C.The time of stop bleeding，hospitalization and hospital costs in group B were higher than those in group C（P<0.01）.The rate of rebleeding was higher in group A than that in group C，and the rate of operation was higher than that of group B and C（P<0.05）.Conclusion Painless Endoscopic injection of hemostatic combined with high doses of esomeprazole in patients with peptic ulcer bleeding treatment can improve the hemostatic effect，reduce the incidence of rebleeding.

[Key words]Peptic ulcer；Bleeding；Painless endoscopy；Esomeprazole

消化性潰疡为消化系统的常见病、多发病，消化性溃疡出血为常见严重并发症之一，为临床急危重症，如不能及时、有效止血可引起患者失血性休克，危及患者生命。随着内镜在临床中普及应用，内镜直视下注射止血在临床中广泛应用，可迅速、有效止血，缩短患者住院时间和康复时间，降低医疗费用[1]。但临床中单纯通过内镜注射止血后10%～30%患者可发生再次出血，国内外指南明确指出，抑酸治疗为促进消化性溃疡出血愈合，降低再出血发生风险的关键治疗方法[2]。埃索美拉唑为临床中常用抑酸药物，不同使用剂量药效和安全性不尽相同，为探究无痛内镜下注射止血联合大剂量埃索美拉唑在消化性溃疡出血患者中治疗效果，研究报道如下。endprint

1资料与方法