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[目的]观察谷氨酰胺联合奥美拉唑治疗新生儿上消化道出血的临床疗效。[方法]选取2012年1月~2014年12月我院儿科治疗的上消化道出血新生儿224例,使用随机数字法分为奥美拉唑常规治疗对照组(对照组)和L-谷氨酰胺呱仑酸钠联合奥美拉唑治疗观察组(观察组),每组112例。检测2组治疗前后超氧化物歧化酶(SOD)和丙二醛(MDA)变化,比较2组的临床疗效和不良反应发生率。[结果]观察组咖啡样物或鲜血停止时间及隐血试验阴转时间分别为(14.27±3.52)h和(25.26±6.54)h,均显著低于对照组的(22.16±5.37)h和(51.32±10.32)h(P<0.05和P<0.01)。观察组临床治疗总有效率为92.0%(103/112),显著高于对照组的73.2%(82/112)(P<0.05)。治疗前2组SOD和MDA差异无统计学意义(P>0.05),治疗后2组SOD均显著升高以及MDA均显著减低(P<0.01),但治疗后观察组SOD显著高于对照组以及MDA显著低于对照组(P<0.05)。观察组不良反应发生率为9.8%(11/112),对照组不良反应发生率为8.0%(9/112),治疗期间2组临床不良反应发生率差异无统计学意义(P>0.05)。[结论]谷氨酰胺联合奥美拉唑可以显著改善上消化道出血新生儿氧化应激状态,临床疗效显著,使用安全,值得进一步的临床推广使用。
[Objective] To observe the clinical efficacy of glutamine combined with omeprazole in the treatment of neonatal upper gastrointestinal bleeding. [Methods] Totally 224 neonates with upper gastrointestinal hemorrhage treated in our hospital from January 2012 to December 2014 were randomly divided into the control group (control group) and L-glutamine Amilorbate sodium combined omeprazole treatment group (observation group), 112 cases in each group. The changes of superoxide dismutase (SOD) and malondialdehyde (MDA) in the two groups before and after treatment were compared. The clinical efficacy and the incidence of adverse reactions in the two groups were compared. [Results] The stopping time of coffee sample or blood and the time of occult blood test in the observation group were (14.27 ± 3.52) h and (25.26 ± 6.54) h respectively, which were significantly lower than those in the control group (22.16 ± 5.37 h and (51.32 ± 10.32) h (P <0.05 and P <0.01). The total effective rate of clinical observation in the observation group was 92.0% (103/112), which was significantly higher than that of the control group (73.2%, 82/112) (P <0.05). There was no significant difference in SOD and MDA between the two groups before treatment (P> 0.05). After treatment, both SOD were significantly increased and MDA were significantly decreased (P <0.01), but after treatment, SOD in observation group was significantly higher than that in control group MDA was significantly lower than the control group (P <0.05). The incidence of adverse reactions in the observation group was 9.8% (11/112), and the incidence of adverse reactions in the control group was 8.0% (9/112). There was no significant difference in the incidence of adverse reactions between the two groups during the treatment (P> 0.05). [Conclusion] Combination of glutamine and omeprazole can significantly improve the oxidative stress in neonates with upper gastrointestinal hemorrhage. The clinical effect is significant, and it is safe to use. It deserves further clinical use.