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目的探究消化性溃疡并发上消化道出血患者引入内镜介入治疗联合质子泵抑制剂三联疗法的临床成效。方法选取宝鸡市高新人民医院消化内科于2012年7月至2015年4月收治的86例消化性溃疡并发上消化道出血患者,用随机数字表法分为联合治疗组和对照组,每组43例。其中对照组给予质子泵抑制剂三联疗法,联合治疗组则在对照组基础上联合应用内镜介入治疗。记录两组患者分别于治疗后8、16、24及48 h的止血情况及空腹胃液p H值,并比较两组不良事件发生率及临床疗效。结果联合治疗组在治疗后8、16、24及48 h止血率均高于对照组,差异均有统计学意义(P<0.05)。与本组治疗前相比,两组患者治疗后的p H值均有所升高,差异均有统计学意义(P<0.05)。联合治疗组总有效率为95.3%(41/43),高于对照组(81.4%,35/43),差异有统计学意义(P<0.05)。两组患者均未发生严重不良反应,其中对照组出现3例轻微恶心、呕吐、腹胀,联合治疗组则出现2例轻微恶心及呕吐。结论内镜介入联合质子泵抑制剂三联疗法应用于消化性溃疡并发上消化道出血者,能达到快速止血及抑酸效果,且安全性可靠,值得在临床上推广。
Objective To investigate the clinical efficacy of triple therapy of endoscopic interventional therapy combined with proton pump inhibitor in patients with peptic ulcer complicated by upper gastrointestinal bleeding. Methods Eighty-six patients with peptic ulcer complicated with upper gastrointestinal bleeding admitted to Baoji High-tech People’s Hospital of Gastroenterology from July 2012 to April 2015 were divided into combined treatment group and control group with random number table example. The control group was given proton pump inhibitor triple therapy, the combination therapy group was based on the control group combined with endoscopic intervention. The hemostatic status and p H value of fasting gastric juice at 8, 16, 24 and 48 h after treatment were recorded. The incidence of adverse events and the clinical effect were compared between the two groups. Results The hemostatic rate of the combined treatment group at 8, 16, 24 and 48 h after treatment was significantly higher than that of the control group (P <0.05). Compared with the group before treatment, p values increased after treatment in both groups, with statistical significance (P <0.05). The total effective rate was 95.3% (41/43) in the combined treatment group, which was significantly higher than that in the control group (81.4%, 35/43) (P <0.05). There were no serious adverse reactions in both groups, including 3 cases of slight nausea, vomiting and bloating in the control group, and 2 cases of slight nausea and vomiting in the combined treatment group. Conclusion The combination of endoscopic intervention and proton pump inhibitor triple therapy for patients with peptic ulcer complicated by upper gastrointestinal bleeding can achieve rapid hemostasis and acid suppression and is safe and reliable. It is worth to be popularized clinically.