兰索拉唑联合血凝酶治疗胃癌与消化性溃疡合并出血临床效果比较研究
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摘要
目的比较兰索拉唑联合血凝酶治疗胃癌与消化性溃疡合并出血的临床效果。方法将上海健康医学院附属上海市浦东新区周浦医院自2016年1月至2018年9月收治的70例胃癌合并出血患者纳入胃癌组,86例消化性溃疡合并出血患者纳入溃疡组。所有患者均接受兰索拉唑联合血凝酶治疗。比较两组止血有效率,以及止血有效患者的平均止血时间、再出血率、并发症发生率。结果止血效果比较,胃癌组显效34例、有效18例、无效18例,有效率为74.3%(52/70);溃疡组显效58例、有效21例、无效7例,有效率为91.9%(79/86)。两组止血有效率比较,差异有统计学意义(P<0.05)。两组止血有效患者中,溃疡组患者平均止血时间为(1.06±0.42)h,明显短于胃癌组的(2.23±0.79)h,差异有统计学意义(P<0.05);溃疡组患者再出血率为11.4%(9/79),明显低于胃癌组的40.4%(21/52),差异有统计学意义(P<0.05);溃疡组患者发生恶心1例、心悸4例、短期眩晕1例,并发症发生率为7.6%(6/79);胃癌组患者发生恶心3例、心悸3例、短期眩晕11例,并发症发生率为32.7%(17/52)。两组并发症发生率比较,差异有统计学意义(P<0.05)。结论与胃癌合并出血患者比较,兰索拉唑联合血凝酶治疗消化性溃疡合并出血患者更具优势。因此,在临床治疗过程中,明确病因并对症支持治疗会发挥更好的效果。
Objective To investigate the clinical effect of lansoprazole combined with hemocoagulase in the treatment of gastric cancer and peptic ulcer with hemorrhage.Methods A retrospective study was performed on 70 cases of patients with gastric cancer combined hemorrhage(gastric group) and 86 cases of patients with peptic ulcer combined hemorrhage were admitted from January 2016 to September 2018.All patients were treated with lansoprazole combined with hemocoagulase.The hemostasis efficiency,average hemostasis time,re-bleeding rate and complication rate of patients with effective hemostasis were compared between the two groups.Results Compared with the hemostatic effect,34 cases showed significant effect,18 cases were effective and 18 cases were ineffective in the gastric cancer group,and the effective rate was 74.3%(52/70).The effective rate was 91.9%(79/86).The hemostatic efficiency of the two groups was compared,and the difference was statistically significant(P<0.05).Among the patients with effective hemostasis in the two groups,the average hemostasis time in the ulcer group was(1.06±0.42) hours,significantly shorter than that in the gastric cancer group(2.23±0.79) hours(P<0.05).The re-bleeding rate of patients in the ulcer group was 11.4%(9/79),significantly lower than 40.4%(21/52) in the gastric cancer group(P<0.05).One case of nausea,four cases of palpitation,and one case of short-term vertigo occurred in the ulcer group,with a complication rate of 7.6%(6/79);3 cases of nausea,3 cases of palpitation,and 11 cases of short-term vertigo occurred in the gastric cancer group,with a complication rate of 32.7%(17/52).The difference in the incidence of complications between the two groups was statistically significant(P<0.05).Conclusion Lansoprazole combined with hemocoagulase has more advantages in the treatment of peptic ulcer combined with hemorrhage than in the treatment of gastric cancer combined with hemorrhage.Therefore,in the clinical treatment process,the clear etiology and symptomatic support treatment will play a better effect.
Objective To investigate the clinical effect of lansoprazole combined with hemocoagulase in the treatment of gastric cancer and peptic ulcer with hemorrhage.Methods A retrospective study was performed on 70 cases of patients with gastric cancer combined hemorrhage(gastric group) and 86 cases of patients with peptic ulcer combined hemorrhage were admitted from January 2016 to September 2018.All patients were treated with lansoprazole combined with hemocoagulase.The hemostasis efficiency,average hemostasis time,re-bleeding rate and complication rate of patients with effective hemostasis were compared between the two groups.Results Compared with the hemostatic effect,34 cases showed significant effect,18 cases were effective and 18 cases were ineffective in the gastric cancer group,and the effective rate was 74.3%(52/70).The effective rate was 91.9%(79/86).The hemostatic efficiency of the two groups was compared,and the difference was statistically significant(P<0.05).Among the patients with effective hemostasis in the two groups,the average hemostasis time in the ulcer group was(1.06±0.42) hours,significantly shorter than that in the gastric cancer group(2.23±0.79) hours(P<0.05).The re-bleeding rate of patients in the ulcer group was 11.4%(9/79),significantly lower than 40.4%(21/52) in the gastric cancer group(P<0.05).One case of nausea,four cases of palpitation,and one case of short-term vertigo occurred in the ulcer group,with a complication rate of 7.6%(6/79);3 cases of nausea,3 cases of palpitation,and 11 cases of short-term vertigo occurred in the gastric cancer group,with a complication rate of 32.7%(17/52).The difference in the incidence of complications between the two groups was statistically significant(P<0.05).Conclusion Lansoprazole combined with hemocoagulase has more advantages in the treatment of peptic ulcer combined with hemorrhage than in the treatment of gastric cancer combined with hemorrhage.Therefore,in the clinical treatment process,the clear etiology and symptomatic support treatment will play a better effect.
引文
[1] 杨燕峰,董雪伟.阿帕替尼治疗中晚期胃癌的临床疗效及预后影响因素[J].实用癌症杂志,2017,32(8):1318-1320.
[2] 李大伟,林飞鹤,谢春发,等.胃癌并发急性大出血的临床分析及诊治探讨(附82例报告)[J].中国现代医学杂志,2004,14(19):46-47.
[3] 刘晓政.5种质子泵抑制剂联合健胃愈疡胶囊治疗消化性溃疡的成本-效果分析[J].中国现代医学杂志,2018,28(4):105-110.
[4] 丁展华.泮托拉唑与奥美拉唑治疗老年消化性溃疡的疗效对比[J].临床检验杂志(电子版),2017,6(2):232.
[5] 吴雅鋆,黄永德.幽门螺杆菌感染与消化性溃疡患者血清中IL-6、IL-8、IL-2相关性临床观察[J].临床军医杂志,2017,45(1):38-41.
[6] 廖芳梅.序贯联合用药方案治疗消化性溃疡的临床效果观察[J].当代医学,2016,22(3):134-135.
[7] 谢心建.血凝酶、奥美拉唑联合用药治疗消化性溃疡并上消化道出血的疗效观察[J].海峡药学,2016,28(6):230-231.
[8] Millar A,Rostom A,Rasuli P,et al.Upper gastrointestinal bleeding secondary to an aberrant right subclavian artery-esophageal fistula:a case report and review of the literature[J].Can J Gastroenterol,2007,21(6):389-392.
[9] Almadi M,Ghali PM,Constantin A,et al.Recurrent obscure gastrointestinal bleeding:dilemmas and success with pharmacological therapies.Case series and review[J].Can J Gastroenterol,2016,23(9):625-631.
[10] Park S,Ji HS,Gwon DI,et al.Reply to:“re:transcatheter arterial embolization for gastrointestinal bleeding associated with gastric carcinoma:prognostic factors predicting successful hemostasis and survival”[J].J Vasc Interv Radiol,2018,29(5):748.
[11] Hirai A,Takeuchi T,Takahashi Y,et al.Comparison of the effects of vonoprazan and lansoprazole for treating endoscopic submucosal dissection-induced artificial ulcers[J].Dig Dis Sci,2018,63(4):974-981.
[12] 唐慧敏.探讨兰索拉唑、奥曲肽、血凝酶三药联用治疗老年急性上消化道出血的疗效[J].中国现代药物应用,2018,2:75-77.
[2] 李大伟,林飞鹤,谢春发,等.胃癌并发急性大出血的临床分析及诊治探讨(附82例报告)[J].中国现代医学杂志,2004,14(19):46-47.
[3] 刘晓政.5种质子泵抑制剂联合健胃愈疡胶囊治疗消化性溃疡的成本-效果分析[J].中国现代医学杂志,2018,28(4):105-110.
[4] 丁展华.泮托拉唑与奥美拉唑治疗老年消化性溃疡的疗效对比[J].临床检验杂志(电子版),2017,6(2):232.
[5] 吴雅鋆,黄永德.幽门螺杆菌感染与消化性溃疡患者血清中IL-6、IL-8、IL-2相关性临床观察[J].临床军医杂志,2017,45(1):38-41.
[6] 廖芳梅.序贯联合用药方案治疗消化性溃疡的临床效果观察[J].当代医学,2016,22(3):134-135.
[7] 谢心建.血凝酶、奥美拉唑联合用药治疗消化性溃疡并上消化道出血的疗效观察[J].海峡药学,2016,28(6):230-231.
[8] Millar A,Rostom A,Rasuli P,et al.Upper gastrointestinal bleeding secondary to an aberrant right subclavian artery-esophageal fistula:a case report and review of the literature[J].Can J Gastroenterol,2007,21(6):389-392.
[9] Almadi M,Ghali PM,Constantin A,et al.Recurrent obscure gastrointestinal bleeding:dilemmas and success with pharmacological therapies.Case series and review[J].Can J Gastroenterol,2016,23(9):625-631.
[10] Park S,Ji HS,Gwon DI,et al.Reply to:“re:transcatheter arterial embolization for gastrointestinal bleeding associated with gastric carcinoma:prognostic factors predicting successful hemostasis and survival”[J].J Vasc Interv Radiol,2018,29(5):748.
[11] Hirai A,Takeuchi T,Takahashi Y,et al.Comparison of the effects of vonoprazan and lansoprazole for treating endoscopic submucosal dissection-induced artificial ulcers[J].Dig Dis Sci,2018,63(4):974-981.
[12] 唐慧敏.探讨兰索拉唑、奥曲肽、血凝酶三药联用治疗老年急性上消化道出血的疗效[J].中国现代药物应用,2018,2:75-77.
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