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目的:观察雷钡拉唑钠三联疗法治疗难治性消化性溃疡的临床疗效,探讨难治性溃疡的有效治疗方法。方法:对有上腹痛、嗳气、反酸等症状,经胃镜检查确诊的且治疗前曾用过雷尼替丁、法莫替丁等H2受体拮抗剂和奥美拉唑或泮托拉唑等质子泵抑制剂正规治疗的消化性溃疡患者,改用雷钡拉唑钠10 mg,每晨一次口服,克拉霉素0.5 Bid,替硝唑1.0 Bid,疗程4周,每例均于治疗前和疗程结束后进行临床症状评估及电子胃镜和血、尿常规、肝功能检查,观察临床症状改善和胃镜下溃疡的愈合情况以及Hp的阴转率。结果:54例中痊愈16例,显效29例,有效6例,无效3例,总有效率94.44%;治疗前合并Hp感染者52例,治疗后Hp阳性者2例,Hp根除率为96.15%(50/52);所有的患者治疗后血、尿常规及肝肾功能未见异常变化。结论:雷钡拉唑钠三联疗法能有效的治疗难治性消化性溃疡,不失为治疗难治性溃疡的最佳选择方案,值得推广应用。
Objective: To observe the clinical efficacy of barium rabazole triple therapy in the treatment of refractory peptic ulcer, and to explore the effective treatment of refractory ulcer. Methods: The patients with upper abdominal pain, belching, acid reflux and other symptoms were confirmed by gastroscopy and treated with H2 receptor antagonists such as ranitidine, famotidine and omeprazole or pantoprazole Proton pump inhibitors and other formal treatment of peptic ulcer patients, switch to barium lamazole 10 mg, oral once every morning, clarithromycin 0.5 Bid, tinidazole 1.0 Bid, the course of 4 weeks, each case before treatment And after the end of treatment for clinical symptoms assessment and gastroscopy and blood, urine, liver function tests to observe the improvement of clinical symptoms and endoscopic ulcer healing and Hp vaginal conversion rate. Results: Among the 54 cases, 16 cases were cured, 29 cases were markedly effective, 6 cases were effective, 3 cases were ineffective and the total effective rate was 94.44%. Among the 52 patients with Hp infection before treatment, there were 2 cases with Hp positive and the Hp eradication rate was 96.15% (50/52). No abnormal changes of blood, urine, liver and kidney function were seen in all patients after treatment. Conclusion: Barium rabazole triple therapy can effectively treat refractory peptic ulcer, after all, the best choice for the treatment of refractory ulcer, which is worth popularizing and applying.