不同联合用药方案救治非甾体类抗炎药物致上消化道出血的临床疗效

摘要

目的：比较分析不同联合用药方案治疗非甾体类抗炎药物（ NSAIDs）致上消化道出血的急诊患者的临床疗效及不良反应发生率。方法选取2008－01～2014－08急诊送入我院急救部接受治疗的248例因服用NSAIDs，经内镜检查证实为消化性溃疡并发出血患者作为研究对象，随机分为两组：埃索美拉唑组140例（应用埃索美拉唑针剂联合尖吻蛇毒血凝酶粉针剂及口服或鼻饲冻干粉血凝酶治疗），奥美拉唑组108例（应用奥美拉唑针剂联合尖吻蛇毒血凝酶粉针剂及口服或鼻饲冻干粉血凝酶治疗）。比较分析两组疗效、临床症状消失时间及不良反应发生率。结果两组临床总有效率分别为97．85％、88．88％。埃索美拉唑组显著高于奥美拉唑组，经卡方检验，差异有统计学意义（P ＜0．05）；两组临床症状平均消失时间分别为（3．2±2．1）d、（4.8±1．9）d，埃索拉唑组明显短于奥美拉唑组，经方差分析，差异有统计学意义（P＜0．05）；两组患者不良反应发生率差异无统计学意义（P＞0．05）。结论埃索美拉唑联合尖吻蛇毒血凝酶、冻干血凝酶粉治疗NSAIDs致上消化道出血的临床疗效优于奥美拉唑联合尖吻蛇毒血凝酶和冻干血凝酶粉，止血作用确切，可有效地缩短患者入住急诊重症监护病房（ EICU）的时间，是较理想的急诊处置措施。%Objective To analyze clinical haemostatic effect and incidences of adverse reactions of two different combination regimens for patients who suffered from upper gastrointestinal haemorrhage because of taking nonsteroidal anti-inflammatory drugs.Methods 248 cases peptic ulcer patients with upper gastrointestinal haemorrhage who visited our emergency room receiving treatment from January 2008 to August 2014 were randomly divided into two groups: group Esomeprazolc ( 140 patients ) and control group Omeprazolc ( 108 patients ) were treated with different treatment regimen.The efficacy, adverse reactions of test group and control group were comparative analyzed.Results The clinical total effective rate of test group and control group were 97.85% and 88.88%, respectively.Test group was significantly higher than control Group, by chi-square test (P<0.05).The average disappearance time of clinical symptoms in test group and control group were (3.2 ±2.1) d and (4.8 ±1.9) d, respectively.Test group was significantly shorter than control Group by analysis of variance (P<0.05). The adverse reaction rates of test group and control group by the chi -square test ( P >0.05 ) . Conclusion Esomeprazole united hemocoagulase treatment gastrointestinal bleeding caused by nonsteroidal anti-inflammatory drugs is significantly better than omeprazole united hemocoagulase.Test group, which has hemostatic effect exactly, can effectively shorten the time of the patients stay in EICU and is the ideal emergency disposal measures.