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目的:观察奥美拉唑联合谷氨酰胺治疗新生儿上消化道出血的效果及对患儿氧化应激状态的影响。方法:选取2014年1月至2016年6月我院收治的上消化道出血新生儿104例,采用随机数表法分为对照组和观察组各52例。对照组给予奥美拉唑0.8 mg/kg静脉滴注,2次/天;观察组在对照组基础上加用谷氨酰胺1.5 mg/kg静脉滴注,1次/天。两组患儿均治疗3 d。治疗前后采用分光光度分析法检测患儿血清超氧化物歧化酶(SOD)、比色法检测丙二醛(MDA)水平,观察临床疗效和不良反应发生情况。结果:治疗前,两组患儿SOD、MDA比较差异无统计学意义(P>0.05);治疗后,观察组患儿SOD的升高幅度、MDA的降低幅度均大于对照组,差异有统计学意义(P<0.05)。观察组出血停止时间、隐血转阴时间均短于对照组(P<0.05);观察组总有效率92.3%,高于对照组的80.8%,但差异无统计学意义(P>0.05);两组不良反应发生率比较差异无统计学意义(P>0.05)。结论:奥美拉唑联合谷氨酰胺治疗新生儿上消化道出血,可有效抑制患儿的氧化应激反应,临床疗效显著,使用安全。
Objective: To observe the effect of omeprazole combined with glutamine in the treatment of neonatal upper gastrointestinal bleeding and its effect on oxidative stress in children. Methods: From January 2014 to June 2016, 104 cases of newborn infants with upper gastrointestinal bleeding admitted to our hospital were divided into control group and observation group with 52 cases in each group. The control group was given omeprazole 0.8 mg / kg intravenously, twice a day; the observation group was given intravenous infusion of glutamine 1.5 mg / kg once a day on the basis of the control group. Two groups of children were treated for 3 days. Before and after treatment, the serum superoxide dismutase (SOD) in children was detected by spectrophotometry. The level of malondialdehyde (MDA) was detected by colorimetry. The clinical efficacy and adverse reactions were observed. Results: Before treatment, there was no significant difference in SOD and MDA between the two groups (P> 0.05). After treatment, the increase of SOD and the decrease of MDA in the observation group were greater than those in the control group Significance (P <0.05). The stopping time of hemorrhage and the time of occult bleeding in the observation group were shorter than those in the control group (P <0.05). The total effective rate in the observation group was 92.3%, higher than that in the control group (80.8%), but the difference was not statistically significant (P> 0.05) The incidence of adverse reactions was no significant difference (P> 0.05). Conclusion: Omeprazole combined with glutamine in the treatment of neonatal upper gastrointestinal bleeding can effectively inhibit the oxidative stress in children with significant clinical efficacy and safe use.