cqvip:This study sought to determine if high- dose omeprazole infusion could improve the control of rebleeding in patients with comorbid illnesses and bleeding peptic ulcers. After achieving hemostasis by endoscopy, 105 patients were randomized into high- dose (n = 52) and low- dose (n = 53) groups, receiving 200 and 80 mg/day omeprazole, respectively, as a continuous infusion for 3 days. Thereafter, oral omeprazole, 20 mg/day, was given. The cumulative rebleeding rates comparatively rose in both groups (high- dose vs. low- dose group), beginning on day 3 (15.4% vs. 11.3% ), day 7 (19.6% vs. 20% ), and day 14 (32.7% vs. 28.9% ), until day 28 (35.4% vs. 33.3% ), and were not significantly different between the two groups (P > 0.50). Multiple logistic regression confirmed that a serum albumin level< 3 g/dL was an independent factor associated with rebleeding (P = 0.002). For patients with comorbidities, 3- day omeprazole infusion, despite increasing the daily dose from 80 to 200 mg, was not adequate to control peptic ulcer rebleeding.
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