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目的 :评估食道静脉曲张破裂出血经内镜食道静脉套扎术治疗后 ,辅助静脉应用大剂量质子泵抑制剂洛赛克 ,能否预防和降低该病的复发性出血率及继发性溃疡发生率。方法 :133例食道静脉曲张破裂出血已成功实施内镜食道静脉套扎术 ,术后将患者随机分为两组 :洛赛克组 (6 7例 ) ,安慰剂组 (6 6例 ) ,分别接受洛赛克或安慰剂治疗。首先静脉注射洛赛克或安慰剂 80mg ,随后以每小时 8mg维持静滴 72h ,其后洛赛克组继续服洛赛克胶囊 2 0mg ,1次 /d ;安慰剂组口服安慰剂胶囊 2 0mg ,1次 /d ;共 8周。疗程完成后复查胃镜进行评估。结果 :洛赛克组的复发性出血率为 7.5 % ,明显低于安慰剂组 (2 6 .1% ) ,两组比较有显著性差异 (P <0 .0 1)。洛赛克组的继发性溃疡发生率为 3% ,明显低于安慰剂组 30 .7% ,有显著性差异 (P <0 .0 5 )。术后随访 3个月 ,洛赛克组有 3例死亡 ,安慰剂组有 8例死亡 ,洛赛克组的死亡比例低于安慰剂组。结论 :食道静脉曲张破裂出血经内镜食道静脉成功套扎术后辅助静脉应用大剂量洛赛克可降低其复发性出血率 ,减少需再次内镜下治疗或转外利 ,手术的比例 ,并能降低继发性溃疡的发生率 ,降低食道静脉套扎术后的死亡率 ,减少住院天数 ,在临床治疗上取得满意疗效。
Objective: To evaluate whether esophageal variceal bleeding after endoscopic esophageal variceal ligation assisted intravenous injection of high-dose proton pump inhibitor Losec could prevent and reduce the incidence of recurrent hemorrhagic disease and secondary ulcer rate. Methods: 133 cases of esophageal variceal bleeding have been successfully implemented endoscopic esophageal varicose vein ligation, the patients were randomly divided into two groups: Losec group (67 cases) and placebo group (66 cases), respectively Receive Losec or placebo treatment. The first intravenous injection of Losec or placebo 80mg, followed by intravenous infusion of 8mg per hour for 72h, then Losec group continued to take Losec capsules 20mg, 1 / d; placebo group placebo capsules 20mg , 1 time / d; a total of 8 weeks. Review the gastroscope after the course of treatment is evaluated. Results: The recurrent hemorrhage rate in Losec group was 7.5%, which was significantly lower than that in placebo group (26.1%). There was significant difference between the two groups (P <0.01). The incidence of secondary ulcer in the Losec group was 3%, which was significantly lower than that in the placebo group (30.7%) (P <0.05). Three months after the surgery, 3 died in the Losec group, 8 died in the placebo group and less in the Losec group than in the placebo group. CONCLUSIONS: The esophageal variceal hemorrhage esophageal varices can effectively reduce the rate of recurrent hemorrhage, reduce the need of re-endoscopic treatment or turn the benefit and surgery, Can reduce the incidence of secondary ulcers, reduce the mortality after esophageal vein ligation, reduce the number of days of hospitalization, and achieved satisfactory results in clinical treatment.