纤维蛋白黏合剂与艾司奥美拉唑钠治疗消化性溃疡出血的疗效研究

Study on the Efficacy of Fibrin Adhesive and Esomeprazole Sodium in the Treatment of Peptic Ulcer Bleeding

关键词:  纤维蛋白黏合剂|艾司奥美拉唑钠|消化性溃疡出血|临床疗效

Key words:  fibrin adhesive|esomeprazole sodium|peptic ulcer bleeding|clinical efficacy

摘要:

目的 探讨纤维蛋白黏合剂与艾司奥美拉唑钠治疗消化性溃疡出血的临床疗效。方法 筛选2015年10月-2018年10月收入海南省人民医院治疗的消化性溃疡出血患者78例，按照治疗方法分为对照组36例和实验组42例。对照组给予内镜下纤维蛋白黏合剂止血治疗，实验组给予纤维蛋白黏合剂联合艾司奥美拉唑钠治疗。观察2组疗效，包括止血成功率、再出血率等；观察2组患者在治疗期间的不良反应发生率。结果 对照组止血成功率为100%，实验组止血成功率为97.5%。对照组患者24 h再出血率为11.1%，实验组患者24 h再出血率为2.6%；对照组患者168 h再出血率为11.1%，实验组患者168 h再出血率为0.0%。对照组患者治疗后的血红蛋白水平上升趋势弱于实验组患者；对照组患者治疗后的消化道症状评分下降趋势弱于实验组患者，对照组患者治疗后溃疡面积大于实验组患者，Rockall得分高于实验组患者。对照组患者治疗后呕血、黑便发生率高于实验组患者。结论 纤维蛋白黏合剂联合艾司奥美拉唑钠治疗消化性溃疡出血能够有效降低患者术后的再出血率，不会引起严重的不良反应事件，可作为安全有效的治疗方案在临床进行推广。

Abstract:

OBJECTIVE To explore the clinical efficacy of fibrin adhesive and esomeprazole sodium in the treatment of peptic ulcer bleeding. METHODS From October 2015 to October 2018, 78 patients admitted to Hainan General Hospital for treatment of peptic ulcer bleeding were divided into control group 36 cases and experimental group 42 cases according to the treatment method. The control group was treated with fibrin adhesive under gastroscope to stop bleeding, and the experimental group was treated with fibrin adhesive combined with esomeprazole sodium. The efficacy of the two groups including the success rate of hemostasis, rebleeding rate, etc. was observed; the incidence of adverse reactions in the two groups during the treatment was observed. RESULTS The success rate of hemostasis in the control group was 100%, and that in the experimental group was 97.5%. The 24 h rebleeding rate of the control group was 11.1%, the 24 h rebleeding rate of the experimental group was 2.6%; the 168 h rebleeding rate of the control group was 11.1%, and the 168 h rebleeding rate of the experimental group was 0.0%. The increasing trend of hemoglobin level in the control group after treatment was weaker than that of the experimental group; the decreasing trend of the gastrointestinal symptoms score of the control group after treatment was weaker than that of the experimental group, the ulcer area of the control group was larger than that of the experimental group, and Rockall score was higher than that of the experimental group. The incidence of hematemesis and melena after treatment in the control group was higher than that in the experimental group. CONCLUSION Fibrin adhesive combined with esomeprazole sodium in the treatment of peptic ulcer bleeding can effectively reduce the postoperative rebleeding rate of patients without causing serious adverse events, and can be promoted as a safe and effective treatment in the clinic.