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目的分析大剂量奥美拉唑治疗老年胃溃疡合并出血的疗效。方法选择2009年6月—2012年6月收治的78例老年胃溃疡合并出血患者作为研究对象,随机分成对照组和观察组各39例。两组患者均给予常规对症治疗。对照组给予奥美拉唑40 mg加入生理盐水100 ml静脉滴注,12 h/次。观察组给予大剂量奥美拉唑首次80 mg静脉推注,随后给予8 mg/h的静脉滴注。两组治疗3 d后,均改为奥美拉唑肠溶片口服,1次/d,20 mg/次,1个月为1个疗程。计量资料比较采用t检验,计数资料比较采用χ2检验,P<0.05为差异有统计学意义。结果治疗后观察组患者≤3 d、4~30 d、31 d~3个月的再次出血率(7.69%、0、0)明显低于对照组(20.51%、5.13%、2.56%)(P<0.05)。观察组总有效率为94.87%,对照组为76.92%,比较差异有统计学意义(P<0.05)。结论采用大剂量奥美拉唑治疗老年胃溃疡合并出血患者,能有效提高患者的临床治疗效果,同时降低了再出血的风险,适合在临床推广应用。
Objective To analyze the efficacy of high-dose omeprazole in the treatment of elderly patients with gastric ulcer combined with bleeding. Methods Seventy-eight elderly patients with gastric ulcer combined with hemorrhage admitted from June 2009 to June 2012 were randomly divided into control group and observation group (39 cases each). Two groups of patients were given conventional symptomatic treatment. Control group was given omeprazole 40 mg by adding 100 ml of saline intravenously, 12 h / time. The observation group was given the first 80 mg IV bolus of high-dose omeprazole followed by 8 mg / h IV infusion. After 3 days of treatment, the two groups were changed to omeprazole enteric-coated tablets orally once a day, 20 mg once daily for one course of treatment. Measurement data were compared using t test, count data were compared using χ2 test, P <0.05 for the difference was statistically significant. Results After treatment, the rate of rebleeding (7.69%, 0,0) in observation group ≤3 d, 4 ~ 30 d and 31 d ~ 3 months was significantly lower than that in control group (P = 20.51%, 5.13%, 2.56% <0.05). The total effective rate was 94.87% in the observation group and 76.92% in the control group, the difference was statistically significant (P <0.05). Conclusion High-dose omeprazole in elderly patients with gastric ulcer combined with bleeding can effectively improve the clinical treatment of patients, while reducing the risk of rebleeding, suitable for clinical application.