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目的探讨大剂量奥美拉唑治疗老年胃溃疡并上消化道出血的临床疗效。方法选取兴安县人民医院2015年3月—2016年3月收治的胃溃疡并上消化道出血患者156例,随机分为对照组和观察组,各78例。患者入院后均给予常规方法治疗,对照组患者给予常规剂量奥美拉唑治疗,观察组患者给予大剂量奥美拉唑治疗,两组患者均持续治疗1个月。随访1年,比较两组患者的临床疗效,治疗后3 d、4~30 d、31 d~3个月再出血情况,治疗前及治疗后72 h血压(收缩压、舒张压)、心率、血肌酐及丙氨酸氨基转移酶及不良反应发生情况。结果观察组患者临床疗效优于对照组(P<0.05)。观察组患者治疗后3 d内再出血率、4~30 d再出血率及总出血率低于对照组(P<0.05)。治疗前及治疗72 h后,两组患者收缩压、舒张压、心率、血肌酐及丙氨酸氨基转移酶比较,差异无统计学意义(P>0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论大剂量奥美拉唑治疗老年胃溃疡并上消化道出血临床疗效确切,可快速达到止血效果,预防再出血,且安全性高。
Objective To investigate the clinical efficacy of high-dose omeprazole in the treatment of senile gastric ulcer and upper gastrointestinal bleeding. Methods 156 patients with gastric ulcer and upper gastrointestinal bleeding admitted to Xing’an People’s Hospital from March 2015 to March 2016 were randomly divided into control group and observation group, with 78 cases in each group. The patients were given routine treatment after admission. The patients in the control group were given omeprazole at a regular dose. The patients in the observation group were treated with high-dose omeprazole. Both groups were treated for one month. The patients were followed up for 1 year. The clinical curative effect, the rebleeding of 3 d, 4 ~ 30 d and 31 d ~ 3 months after treatment were compared. The blood pressure (systolic pressure and diastolic blood pressure), heart rate, Serum creatinine and alanine aminotransferase and adverse reactions occurred. Results The clinical efficacy of the observation group was better than that of the control group (P <0.05). In the observation group, the rate of rebleeding within 3 days after treatment, the rate of rebleeding from 4 to 30 days and the rate of total bleeding were lower in the observation group than those in the control group (P <0.05). Before treatment and 72 h after treatment, the systolic blood pressure, diastolic blood pressure, heart rate, serum creatinine and alanine aminotransferase in the two groups showed no significant difference (P> 0.05). Two groups of patients with adverse reactions, the difference was not statistically significant (P> 0.05). Conclusion High-dose omeprazole treatment of elderly patients with gastric ulcer and upper gastrointestinal bleeding clinical curative effect can be quickly reached the hemostatic effect, to prevent rebleeding, and high safety.