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目的探讨质子泵抑制剂(PPIs)在消化性溃疡并发症出血、穿孔和幽门梗阻治疗中的作用。方法对我科2002年8月~2005年8月的消化性溃疡并发出血、穿孔和幽门梗阻的住院病例行回顾性分析,以前1年半病例为对照组,后1年半病例为试验组。结果内镜止血成功后采用PPIs的新用法试验组3d内、30d内再出血率分别为3.22%、6.45%,3d内平均输血量2.38±2.12u,与对照组比较均有显著性差异(P<0.05)。空腹穿孔或穿孔在6h以内者采用PPIs的新用法,试验组3周内穿孔非手术治疗治愈率、中转手术率分别为91.67%、4.17%,与对照组比较均有显著性差异(P<0.05)。幽门良性梗阻者采用PPIs新用法和内镜球囊扩张,成功率达72.73%。结论PPIs新用法对巩固消化性溃疡并发症出血、穿孔和幽门梗阻非手术治疗的疗效起到了举足轻重的作用。
Objective To investigate the role of proton pump inhibitors (PPIs) in the treatment of bleeding, perforation and pyloric obstruction in patients with peptic ulcer complications. Methods A retrospective analysis was performed on inpatients with peptic ulcer bleeding, perforation and pyloric obstruction in our department between August 2002 and August 2005. One year and a half before the case was the control group, and one year and a half after the case was the experimental group. Results The new usage of PPIs after endoscopic hemostasis was successful. The rate of rebleeding within 30 days in experimental group was 3.22% and 6.45% respectively, and the mean blood transfusion in 3 days was 2.38 ± 2.12u, which was significantly different from that in control group (P <0.05). The new usage of PPIs in patients with fasting perforation or perforation was less than 6h. The cure rate of percutaneous non-surgical treatment within 3 weeks in the test group was 91.67% and 4.17%, respectively, which were significantly different from the control group (P <0.05) ). Pyloric obstruction with PPIs new usage and endoscopic balloon dilatation, the success rate of 72.73%. Conclusion The new use of PPIs plays an important role in consolidating the efficacy of non-surgical treatment of peptic ulcer bleeding, perforation and pyloric obstruction.