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目的观察善得定联用奥美拉唑治疗门脉高压性胃病(PHG)上消化道出血的临床疗效,总结门脉高压性胃出血的临床护理。方法将57例经胃镜证实为肝硬化门脉高压性胃病上消化道出血的患者随机分为两组,分别给予善得定和善得定联用奥美拉唑(联合用药组)治疗,通过观察生命体征、呕血、便血估计出血情况,进行对照研究。并记录患者的输血量和药物的不良反应,同时做好健康宣教,加强饮食护理;做好心理护理,解除紧张、恐惧心理,减少出血量。结果善得定组6、24、48 h的完全止血率与联合用药组比较差异无统计学意义(P>0.05),但善得定组12 h的完全止血率显著低于联合用药组(79.3%,P<0.05)。善得定组24 h内完全止血平均所需时间为(11±7)h,显著高于联合用药组(7±4)h,P<0.05;善得定组和联合用药组治疗后7 d的再出血率和生存率比较差异无统计学意义(P>0.05);善得定组和联合用药组不良反应分别为2例和1例,均无严重不良反应,差异无统计学意义。结论善得定能有效、安全控制肝硬化PHG出血,但善得定联用奥美拉唑,则控制出血比单用善得定更为迅速、疗效更佳,为患者争取了抢救机会。
Objective To observe the clinical effect of combination of omeprazole and upper gastrointestinal bleeding in patients with portal hypertension gastropathy (PHG) and to summarize the clinical nursing of portal hypertension. Methods Fifty-seven patients with upper gastrointestinal hemorrhage confirmed by gastroscopy were randomly divided into two groups, and treated with omeprazole (combined treatment group) Vital signs, hematemesis, hematochezia estimated bleeding, control study. And record the patient’s blood transfusion and adverse drug reactions, while doing a good job of health education, diet and strengthen care; good psychological care, relieve tension, fear, reduce blood loss. Results The complete hemostatic rate at 6, 24, and 48 h was not statistically significant (P> 0.05), but the complete hemostasis rate at 12 h was significantly lower than that in the combination group (79.3 %, P <0.05). The average time required for complete hemostasis within 24 hours of Good Decintin group was (11 ± 7) h, significantly higher than that of the combination group (7 ± 4) h, P <0.05; There was no significant difference in the rate of rebleeding and survival between two groups (P> 0.05). The adverse reactions in SHED group and combination group were 2 cases and 1 case, respectively, with no serious adverse reactions, the difference was not statistically significant. Conclusion Good day set can be effective and safe control of cirrhosis of PHG bleeding, but good to be fixed with omeprazole, the control of bleeding is better than single-use set of more rapid, better efficacy for the patient for the rescue opportunity.