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[目的]观察内镜下局部注射奥曲肽同时喷洒胃力康治疗胃溃疡(GU)的疗效。[方法]70例经胃镜证实的活动性GU伴幽门螺杆菌(Hp)阳性的患者随机分为2组,对照组34例,给予洛赛克、甲硝唑、克拉霉素、多潘立酮口服,1周后停用甲硝唑及克拉霉素,其余用至4周。治疗组36例,在对照组治疗的基础上胃镜下于溃疡周边注射奥曲肽0.1 mg加0.9%氯化钠10 ml,注射3~5点,然后用胃力康20.0 g加0.9%氯化钠15 ml经活检孔道通过造影管均匀喷洒在溃疡面上。治疗前后测定2组患者胃黏膜组织的前列腺素E2(PGE2)水平。[结果]治疗组治愈率94.3%,明显优于对照组70.6%(P<0.05);治疗组治疗后胃黏膜组织PGE2[(2.50±0.58)mg/g]明显高于治疗前[(1.42±0.33)mg/g](P<0.05);而对照组治疗前后PGE2[(1.41±0.32)mg/g,(1.44±0.42)mg/g]则无明显变化。[结论]内镜下局部注射奥曲肽及喷洒胃力康治疗GU,提高胃黏膜组织的PGE2水平,加强胃黏膜的保护作用,可明显提高溃疡的愈合率,缩短疗程,且操作方便,无明显不良反应。
[Objective] To observe the curative effect of local injection of octreotide endoscopy on gastric ulcer (GU). [Methods] Seventy patients with active GU confirmed by gastroscope with Helicobacter pylori (Hp) were randomly divided into two groups. The control group consisted of 34 patients with oral administration of Losec, metronidazole, clarithromycin and domperidone, 1 Metronidazole and clarithromycin were discontinued after the rest of the week, with the remaining 4 weeks. In the treatment group, 36 cases were treated with 10 mg of octreotide 0.1% 0.9% sodium chloride and 3 to 5 minutes after injection in the control group, and then treated with 20.0 g of Wei Li Kang and 0.9% sodium chloride 15 ml through the biopsy tube through the contrast tube evenly sprayed on the ulcer surface. The levels of prostaglandin E2 (PGE2) in gastric mucosa of two groups before and after treatment were measured. [Results] The cure rate of the treatment group was 94.3%, which was significantly better than that of the control group 70.6% (P <0.05). The gastric mucosal PGE2 [(2.50 ± 0.58) mg / g] in the treatment group was significantly higher than that before treatment [ 0.33) mg / g] (P <0.05). However, there was no significant difference in PGE2 [(1.41 ± 0.32) mg / g and (1.44 ± 0.42) mg / g] before and after treatment in the control group. [Conclusion] The local injection of octreotide endoscopy and administration of Wei Li Kang in the treatment of GU can improve the gastric mucosal PGE2 level and enhance the protective effect of gastric mucosa, which can obviously improve the healing rate of ulcer and shorten the course of treatment, and it is easy to operate and has no obvious defect reaction.